Tenet Healthcare Corp. settles with more than 769 patients over allegations that one of its hospitals, Redding Medical Center in California, performed hundreds of unnecessary operations on its patients between 1992 and 2002. A 2002 FBI affidavit alleged that perhaps as many as 50 percent of the heart surgeries and tests performed by doctors at the hospital were not necessary. Of those, as many as a quarter did not even involve patients who had serious heart issues. According to Russell Reiner, the attorney who represented about half the patients, at least 20 patients died after undergoing unnecessary heart surgery at the hospital, while other patients suffered strokes, brain damage, or amputations. Under the terms of the settlement agreement, Tenet will pay the former patients $395 million. [San Francisco Chronicle, 12/22/2004]

Dr. Jonathan Fishbein. [Source: unknown]Government whistleblower Dr. Jonathan Fishbein, in testimony before a panel at the Institute of Medicine, says that federal officials involved in a US-funded study in Uganda endangered the lives of hundreds of patients testing an AIDS drug because of careless and negligent research practices. Fishbein says officials at the National Institutes of Health (NIH) ignored problems with the way the study was being conducted on the AIDS drug, nevirapine, which is used to protect babies in Africa from HIV infection during birth. The consequences of their failure had “grave and sometimes fatal implications for the lives of real patients,” Fishbein tells the panel. Fishbein does not allege that the drug is dangerous or ineffective. Instead, he discusses problems with the researchers involved, citing shoddy data collection, record-keeping and quality control issues. Because of those concerns, he says, the results of the study cannot be trusted. “We can ill afford to entrust the lives of people to invalid data,” he says. NIH has acknowledged that the Uganda research failed to meet required US standards. But it maintains that hundreds of thousands of African babies have been saved by using single doses of the drug to block the AIDS virus and that it can be done safely with those single doses. Nevirapine is an antiretroviral drug used since the 1990s to treat adult AIDS patients and is known to have potentially lethal side effects like liver damage when taken in multiple doses over time. Concerns have been raised over the possibility that the drug may cause long-term resistance in patients to further AIDS treatments. It is marketed in the United States as Viramune. Fishbein says that top officials at NIH became “so heavily invested in the trial’s outcome” that they could not be objective. “The old adage ‘garbage in, garbage out’ is apt,” he says. In 2003, Fishbein helped halt the study for 15 months after auditors, medical experts, and others disclosed problems with the project. But the concerns were dismissed by NIH officials, and the study began again. Documents show NIH knew of problems with the study in early 2002, but did not tell the White House before President Bush launched a $500 million plan that summer to use nevirapine throughout Africa. NIH is attempting to fire Fishbein for what it calls poor performance issues; Fishbein says the firing is retaliation for his speaking out. [Associated Press, 1/4/2005]

The Center for Reproductive Rights (CRR) files a lawsuit against the Food and Drug Administration (FDA) asking that the courts reverse a recent FDA decision not to allow the so-called “morning-after” birth-control drug “Plan B” to be sold without a prescription (see May 6, 2004 and After). The CRR says the FDA’s decision was made based on politics and not science. CCR president Nancy Northrup will say that the FDA’s decision “broke its own rules, held Plan B to a higher standard than other over-the-counter drugs, and [as a result,] women have suffered the consequences.” Testimony and depositions gathered indicate that the FDA indeed placed politics over science in its decision. One scientist says that a deputy FDA commissioner told her that the over-the-counter (OTC) application for Plan B had to be rejected “to appease the administration’s constituents,” and that it could later be quietly approved for adults only (see March 4, 2008). Another scientist testifies that he learned before the 2004 decision was issued that then-FDA commissioner Mark McClellan—the brother of White House press secretary Scott McClellan—had already decided to disapprove the drug even before the FDA’s advisory panel had completed its analysis. However, McClellan will deny the accusation. [Center for Reproductive Rights, 11/14/2005; Savage, 2007, pp. 301-302]

The British medical journal Lancet publishes a paper by FDA scientist David Graham suggesting that tens of thousands of Americans probably died from taking Vioxx, a painkiller that was recalled in September (see September 30, 2004). His study looked at data on 1.4 million Kaiser Permanente patients that took Vioxx, Celebrex, or another non-steroidal anti-inflammatory drug (NSDAID) between 1999 and 2003. The data showed that the risk of having a heart attack or dying from heart problems was 1.6 times higher for patients taking standard-dose Vioxx compared with those using Celebrex. The risk was 3.6 times higher for those on high doses. Graham notes that Vioxx’s potential impact on the patient population was likely severe. Using the risk factors from Merck-sponsored randomized clinical trials, and extrapolating these to the estimated 106.7 million Vioxx patients, Graham says that the drug may have caused cardiovascular problems for 88,000-140,000 Americans. It is estimated that 44 percent of acute myocardial infarction’s are fatal. [Graham et al., 2005 ; London Times, 1/25/2005] In November, Graham told Congress that senior managers at the FDA’s Office of Drug Safety had delayed giving Graham permission to publish this study, even after it had been accepted by Lancet. [US Congress, 11/18/2004 ]

An expert panel convened by the US Food and Drug Administration unanimously agrees that Celebrex, Bextra, and Vioxx “significantly increase the risk of cardiovascular events” such as heart attacks. However the panel does not believe that the risk is so great that these drugs should be banned from the market. (Vioxx was withdrawn from the market voluntarily by its manufacturer in September (see September 30, 2004).) The sales of these drugs should be permitted to continue, but only under strict conditions, the panel says. It also recommends a prohibition on direct marketing to consumers, a patient’s guide for the drug, and a black box warning—the most severe possible—detailing the drug’s cardiovascular side effects. [CNN, 2/18/2005; Washington Times, 2/19/2005] After the vote, the New York Times reveals that 10 of the panel’s 32 members had at one time been paid-consultants to the makers of the drugs in question. In analyzing the votes, the Times discovers that neither Bextra nor Vioxx would have survived the vote if the scientists with connections to the company had not voted. For both Bextra and Vioxx, the industry-connected panelists voted 9 to 1 in favor, while the experts with no ties voted 14 to 8 and 17 to 15 to ban Bextra and Vioxx, respectively. The Times notes in its article that “these votes were deeply important” for the makers of those drugs. After the votes, the shares of Merck and Pfizer increase substantially. In e-mails to the Times, eight of the panelists, responding to questions from the newspaper, say their votes were not influenced by their ties to the companies. Two of the panelists do not respond. One of the panel members, Dr. John Farrar, who has received research support from Pfizer, says, “I think FDA would have a hard time finding people who are good at what they do who never spoke to a pharmaceutical company.” But another panel member, Dr. Curt Furberg, who has no ties, says he was “uncomfortable with the Pfizer-friendly undertone” at the meeting and he felt the industry ties might have contributed to that tone. Furberg adds that it has never been proven that Celebrex, Bextra, or Vioxx offer better pain relief than ibuprofen or more than a dozen other over-the-counter drugs. Daniel E. Troy, the FDA’s former chief counsel and a longtime advocate of drug-maker interests, plays down the importance of the ties, saying that any suggestion that experts’ votes were influenced by industry connections “buys into an overly conspiratorial view of the world.” [New York Times, 2/25/2005]

Anti-abortion activist Eric Rudolph, who has pled guilty to bombing abortion clinics (see January 16, 1997 and January 29, 1998), a gay and lesbian nightclub (see February 21, 1997), and the 1996 Olympics (see July 27, 1996 and After and October 14, 1998) in a series of court proceedings, releases an 11-page “manifesto” that explains the rationale behind his bombing spree. In the document, which the Associated Press terms “[a] sometimes-rambling, sometimes-reflective” statement, Rudolph writes that he considers himself a “warrior” against abortion, which he calls murder, and the US government, which he charges with permitting the “slaughter” of “innocent babies.” Rudolph will receive four life sentences without parole in return for the prosecution removing the death penalty from consideration (see July 18, 2005). He has also alerted authorities to a large stash of explosives he created while hiding in the mountains of western North Carolina. Abortion Providers, Lawmakers 'Legitimate Targets' in 'War' - The “holocaust” of abortion is his driving impulse, Rudolph writes in his statement. Anyone who supports or allows abortion, he writes, is an enemy deserving of death. “Because I believe that abortion is murder, I also believe that force is justified… in an attempt to stop it,” he writes, “whether these agents of the government are armed or otherwise they are legitimate targets in the war to end this holocaust.… Abortion is murder. And when the regime in Washington legalized, sanctioned, and legitimized this practice, they forfeited their legitimacy and moral authority to govern.” Rationale for Bombing Olympics - Rudolph also writes that the Olympic bombing was envisioned as the first in a weeklong campaign of bombings designed to shut down the Olympics, held in Atlanta, and embarrass the US government as a result. He had hoped to use high-grade explosives to shut down the Atlanta power grid and force the termination of the Olympics, but was unable to procure the explosives, and calls the results of his bombing a “disaster.” He writes: “In the summer of 1996, the world converged upon Atlanta for the Olympic Games. Under the protection and auspices of the regime in Washington, millions of people came to celebrate the ideals of global socialism. Multinational corporations spent billions of dollars, and Washington organized an army of security to protect these best of all games. Even though the conception and purpose of the so-called Olympic movement is to promote the values of global socialism, as perfectly expressed in the song Imagine by John Lennon, which was the theme of the 1996 Games even though the purpose of the Olympics is to promote these despicable ideals, the purpose of the attack on July 27 was to confound, anger, and embarrass the Washington government in the eyes of the world for its abominable sanctioning of abortion on demand.” Racist, Homophobic Views - In the document, Rudolph attacks homosexuality as an “aberrant” lifestyle, and blames the government for condoning it. He denies holding racist or anti-Semitic views [Associated Press, 4/13/2005; Associated Press, 4/14/2005; CNN, 4/19/2005] , though his ex-sister-in-law Deborah Rudolph told reporters that Rudolph believed abortion was part of a plot to undermine the white race; she said, “He felt like if woman continued to abort their white babies, that eventually the white race would become a minority instead of a majority.” Others have said that Rudolph told them he believed the Holocaust never occurred. [CNN, 6/15/2002]'Worse to Him than Death' - After Rudolph’s guilty plea, Deborah Rudolph says of the prospects of his life in jail, “Knowing that he’s living under government control for the rest of his life, I think that’s worse to him than death.” [Associated Press, 4/13/2005] Rudolph, Prisoner No. 18282-058, will be incarcerated in a tiny cell in the Federal Correctional Complex in Florence, Colorado, colloquially known as the “Supermax” facility. Rudolph lives on “bomber’s row” along with Ted Kaczynski, the so-called “Unabomber” (see April 3, 1996), Islamist terrorist Ramzi Yousef (see February 7, 1995), “shoe bomber” Richard Reid (see December 22, 2001), and Oklahoma City bomber Terry Nichols (see 8:35 a.m. - 9:02 a.m. April 19, 1995). After his imprisonment, he releases a statement that reads in part, “The talking heads on the news [will] opine that I am ‘finished,’ that I will ‘languish broken and unloved in the bowels of some supermax,’ but I say to you people that by the grace of God I am still here—a little bloodied, but emphatically unbowed.” [Orlando Weekly, 8/24/2006]

A survey of 483 physicians by GfK Market Measures finds that one-third feel drug company sales representatives are “too aggressive or pushy.” Roughly an equal percentage says that many reps are “not knowledgeable.” One general practitioner tells GfK, “It’s silly that a highly trained sales force does not know what their product is used for and they have to ask me.” According to the survey, drug companies Pfizer and Merck are considered by doctors to have the most effective marketing teams. Abbott Laboratories’ sales force is rated as the least effective. [CNN, 9/14/2005]

Anti-abortion extremist Eric Rudolph (see April 14, 2005), whose bombings cost the lives of two people and injured several more, receives four life sentences for his actions. He pled guilty to multiple bombings in return for the death penalty being removed from consideration. One of his victims, nurse Emily Lyons, calls Rudolph a “monster” and a “coward,” and says he deserves death for what he did (see January 29, 1998). Felicia Sanderson, whose husband was slain in the same bombing that maimed Lyons, tells the court: “I want to tell you there is no punishment in my opinion great enough for Eric Rudolph. When Eric Rudolph leaves this earth and has to face final judgment, I’m going to leave the final judgment in God’s hand.” For his part, Rudolph uses the sentencing hearing to lambast abortion clinics and the practice of abortions. The clinics deserved to be bombed, he says, because “[w]hat they did was participate in the murder of 50 children a week. Abortion is murder and because it is murder I believe deadly force is needed to stop it.… Children are disposed of at will. The state is no longer the protector of the innocence [sic].” The director of the Alabama clinic bombed by Rudolph says, “It gives me great delight to know you are going to spend the rest of your life sitting in an 8-by-12 box.” [Associated Press, 7/18/2005]

The New York Times publishes an article suggesting that pharmaceutical companies are using sex to sell their drugs. Physicians interviewed in the article indicate that the sexual marketing of drugs is widespread. “There’s a saying that you’ll never meet an ugly drug rep,” says Dr. Thomas Carli of the University of Michigan. T. Lynn Williamson, a cheering advisor at the University of Kentucky, tells the Times that recruiters from pharmaceutical companies routinely call him looking for prospective sales representatives. “They watch to see who’s graduating,” he explains. “They don’t ask what the major is. Exaggerated motions, exaggerated smiles, exaggerated enthusiasm—they learn those things, and they can get people to do what they want.” He says approximately two dozen cheerleaders from the university, mostly women but also some men, have gone on to work for the drug industry. The newspaper also interviews Gregory C. Webb, the owner of Spirited Sales Leaders, a company that helps former cheerleaders find work in the sales industry. “I’ve had people who are going right out, maybe they’ve been out of school for a year, and get a car and make up to $50,000, $60,000 with bonuses, if they do well,” he explains. His company’s website boasts that a “large number of former Varsity employees have secured sales positions and built successful careers in various fields, such as pharmaceutical and medical sales.” The website’s header combines a large photo of a hospital room with a photo of a cheerleader. [New York Times, 11/28/2005; Spirited Sales Leaders, 7/23/2006]

The Annals of Internal Medicine posts an “early release” version of an article reporting three cases of acute liver failure in previously healthy patients who had taken Ketek. [Los Angeles Times, 6/17/2006] The final version of the article will be published in late March. [Clay et al., 3/21/2006] The FDA, responding to the new data, insists the drug presents no more danger to the liver than other antibiotics. The agency even cites the results of Study 3013, which FDA investigators previously determined relied upon fraudulent data (see October 2001-Fall 2002 and March 25, 2004). [Wall Street Journal, 5/1/2006 ]

The Family Research Council, an organization of religious and social conservatives, sends a letter to the Department of Health and Human Services (HHS) protesting a department Web site that for six years has provided the public with information about gay-related health issues. Two weeks later, the entire Web site disappears. [Savage, 2007, pp. 106]

In an 8-0 decision, the US Supreme Court reverses the findings of earlier courts and finds for the defendants in the NOW v. Scheidler lawsuit (see June 1986, September 22, 1995, and March 29 - September 23, 1997). The Court, ruling on technical grounds (see April 22, 2002), determines that it was improper for the National Organization for Women (NOW) to use laws covering racketeering and organized crime against anti-abortion advocates who committed violence against women’s clinics. The Court also notes that Congress’s 1994 passage of the Freedom of Access to Clinic Entrances (FACE—see May 1994) Act indicated that Congress did not view the law as pertaining to this area. [FindLaw, 2/28/2006; Los Angeles Times, 3/1/2006]

Governor Mike Rounds (R-SD) of South Dakota signs a bill into law that bans almost all abortions in his state. The law makes all abortions illegal except for cases where the mother’s life is at risk. The law is designed to be appealed to the Supreme Court and give that body a chance to overturn the 1973 Roe v. Wade decision (see January 22, 1973). [CBS News, 4/19/2007] In November 2008, South Dakota voters will vote to repeal the law, by a 56 percent-44 percent margin. [Stateline, 11/8/2008]

Dr. Maria Rosa Costanzo presents the findings of a study on the effectiveness of a $14,000 blood filtering device manufactured by Minnesota-based CHF Solutions. The study—performed by Midwest Heart Foundation, but designed with the help of CHF Solutions—concluded that the device does a better job of removing excess fluid from patients with heart failure than intravenous diuretic drugs. Costanzo does not disclose to her audience that CHF Solutions is one of Midwest Heart Foundation’s largest donors—contributing about $180,000 in 2004. She does say that she is a paid consultant of the company and a stockholder. Some doctors criticize the study, noting that subjects of the study may not have taken enough medicine to provide meaningful comparisons. [New York Times, 6/28/2006] Cardiologist Dr. JoAnn Lindenfeld, for example, tells Heartwire, “I wouldn’t view these data as persuasive enough to use it full-scale in a million patients a year with acute decompensated heart failure.” [HeartWire, 3/15/2006]

An Indiana mother and her 17-year-old daughter visit what they think is a Planned Parenthood (PP) clinic to receive counseling about the daughter’s pregnancy. The facility is actually a “crisis pregnancy clinic,” or CPC, operated by anti-abortion activists. The CPC is near the Planned Parenthood clinic, and shares a parking lot with it. According to a PP email alert, the CPC is one of a number of false clinics “designed expressly to lure Planned Parenthood patients and deceive them.” In this case, the CPC staff, pretending to be PP clinic officials, record the girl’s confidential information and make a false “appointment” for her that is to take place in the “other office”—the actual PP clinic. When the girl returns for her appointment, the PP clinicians have no record of her. Moreover, she is met by police, who have been told by the CPC staff that the girl is a minor being forced to have an abortion against her will. In the days and weeks following the encounter, the girl and her family are harassed and stalked by anti-abortion activists. The activists come to her home and call her father’s workplace to “counsel” the family against having an abortion. The PP clinic director later says the girl was “scared to death to leave her house.” The activists even go to the girl’s school and urge her classmates to pressure her not to have an abortion. PP warns that anti-abortion organizations around the country are setting up CPCs (see May 1, 2006), many of which pass themselves off as non-partisan women’s health clinics offering a full range of reproductive services, but in actuality are fronts for those organizations, providing no health services but instead disseminating pamphlets and other information. PP accuses these CPCs of trafficking in “propaganda and intimidation,” and writes: “[A]ccording to The New York Times, there are currently more of these centers in the US than there are actual abortion providers! What’s more, these centers have received $60 million of government grants. They’re being funded by our tax dollars.” The PP blog entry featuring the email alert is later removed from the organization’s site, but is preserved on another Web site. [Planned Parenthood, 4/21/2006] The story is later verified by Planned Parenthood official Jennifer Jorczak. [AlterNet, 5/1/2006]

A study conducted by the American Medical Association (AMA) finds that health insurance companies are becoming near-monopolies. Ninety-five percent of the 294 HMO/PPO metropolitan markets surveyed have a Herfindahl-Hirschman Index (HHI) above 1,800. The HHI is used to determine whether a company’s control of the market warrants antitrust concern. A market with a rating of 1,800 is considered by the Department of Justice to be “highly concentrated.” Sixty-five percent of the companies surveyed have a rating over 3,000. The concentration is apparently the product of a period of intense consolidation within the industry. According to the AMA, there were more than 400 mergers during the preceding ten years. [American Medical Association, 2006 ; Associated Press, 4/18/2006] “Patients do not appear to be benefiting from the consolidation of health insurance markets,” says AMA board member Dr. J. James Rohack. “Health insurers are posting historically high profit margins, yet patient health insurance premiums continue to rise without an expansion of benefits.” [Consumer Affairs, 4/18/2006] The AMA has asked the Department of Justice to take up antitrust action. But the organization says that in spite of the extremely high market concentration, regulators seem uninterested. [Associated Press, 4/18/2006]

The liberal news Web site AlterNet publishes an expose of “crisis pregnancy centers” (CPCs), clinics purporting to be women’s health centers offering pregnancy counseling, including abortions, but in reality operated by anti-abortion organizations (see April 2006). Reporter Amanda Marcotte notes that many CPCs are funded by over $60 million in government grants, and use the money to rent offices near real women’s clinics and health facilities, and rent billboards advertising their services as if they are actual health clinics. She writes: “If you’re facing an unwanted pregnancy, one of the possible solutions would be getting un-pregnant—still a legal, if sometimes difficult-to-find, option in America. But the ‘crisis pregnancy centers’ these signs advertise seek to limit and, in some cases, prevent women from exploring their legal options for health care.” CPCs are being heavily, and increasingly, funded by the Bush administration and conservative legislators earmarking funds in state and local budgets, at the expense of funds for actual women’s clinics. Low-income women are at particular risk for losing services, Marcotte notes. In some cases, she continues, anti-abortion organizations have formed for the specific purpose of obtaining government grants. The history of CPCs goes back at least as far as 1967, when anti-abortion activist Robert Pearson opened the first one as what he called “the service arm of the anti-choice movement.” During the 1980s, according to the pro-choice organization Planned Parenthood, CPCs would often provide shelter to women wanting abortions until the legal deadline for having the procedure had passed; the CPCs would then turn the women out, forcing them to either carry the fetus to term or seek an illegal abortion. By 1985, many states had put an end to CPCs falsely advertising themselves as real health clinics, forcing them to actually offer a minimum level of health care. Marcotte reports that “as a general rule, [CPCs] have few or no paid employees, no medical personnel on staff, and no real facilities to provide any medical care. Generally speaking, the medical treatment provided by the largely volunteer staff is nothing more than handing clients a pregnancy test that could be purchased over the counter for $10.” [AlterNet, 5/1/2006]

Save the Children releases a report ranking the status of mothers and children in 125 countries. The report—based on 10 indicators pertaining to health and education—concludes that Sweden is the best country in the world for mothers and children to live. The US and United Kingdom are tied for tenth place. The US places much lower, however, in infant mortality, ranking second-to-last among 33 industrialized nations. It shares the spot with Hungary, Malta, Poland, and Slovakia with a death rate of nearly 5 per 1,000 babies. Save the Children’s data shows a remarkable difference in mortality rates between white and black infants. According to the report, black babies are twice as likely as white babies to be premature, have a low birth weight, or die at birth. The infant mortality rate among US blacks—9 per 1,000—is closer to the rates of developing nations. For example, in war-torn Colombia the mortality rate is 12 per 1,000. [Save the Children, 5/2006 ; Save the Children, 5/9/2006; Associated Press, 5/10/2006]

In a memo, FDA safety investigators warn that the link between Ketek and liver damage could be more serious than a recent study published in the Annal of Internal Medicine suggested (see January 2006). The memo says there have been 12 cases of liver failure among Ketek patients, including one patient who took only one dose of the medication. Four patients are known to have died, and one had to undergo a liver transplant. They suffered a “profound degree” of liver damage, the memo says. “The rapid tempo and severity of injuries… suggest an acute hypersensitivity-like process.” A review of data on three similar drugs showed far fewer incidents of liver failure, according to the memo. [Los Angeles Times, 6/17/2006]

Dr. Susan Molchan testifies before Congress. [Source: CBS News]Dr. Susan Molchan, a former clinical researcher for the National Institutes of Health (NIH), testifies before Congress that her supervisor at NIH made a secret deal with the pharmaceutical company Pfizer that involved human tissue samples supposedly collected for the public good, but were instead used for Pfizer’s own research and garnered the company millions in profit. [CBS News, 6/14/2006] Molchan testifies before the House Energy and Commerce Subcommittee on Oversight and Investigations [The Scientist, 6/14/2006] that a collection of unused spinal fluid samples, which CBS News describes as a "a treasure trove of biological material, many painfully given up by Alzheimer’s patients" disappeared without a trace from her laboratory freezer at NIH. The samples were slated to be used for NIH studies on Alzheimer’s disease. Molchan says she was told that some of the samples were lost due to freezer malfunctions, but, "nothing solid, nothing that made sense. I never got a handle on what happened to them." [CBS News, 6/14/2006] Procuring the tissue samples alone cost the government $6.4 million, say committee staffers, who spent a year investigating the matter. "It would really be a shame if we find out that the National Institutes of Health has more control over its paper clips and trash cans than it has over its human tissue samples," says committee member Joe Barton (R-TX). [The Scientist, 6/14/2006] Molchan’s testimony, and other data gathered by Congressional investigators, prove that Molchan’s immediate supervisor, Dr. Trey Sunderland, a well-known psychiatric researcher, cut a secret deal with Pfizer at the same time Pfizer was launching and refining a new Alzheimer’s drug. "If individual scientists are making use of that tissue for their own personal gain, that’s something we need to know about it. It’s not the right thing," says House Energy subcommittee chairman Ed Whitfield (R-KY). Sunderland provided Pfizer "access" to 3,200 tubes of spinal fluid, costing the NIH and, as a result, taxpayers, an estimated $6 million. In exchange, Sunderland reportedly received $285,000 in personal compensation. Pfizer’s drug Aricept is now the top-selling drug in the world for treating Alzheimer’s, generating $1.6 billion in sales in 2004. "The more tissue samples you can collect these days and extract genetic information about risk and benefit, that’s the future of drug development around the world," says Dr. Art Caplan, a bio-ethicist at the University of Pennsylvania. The House committee finds that Pfizer itself broke no NIH rules or knew of any wrongdoing by Sunderland, who does not testify before Congress, instead invoking his Fifth Amendment right against self-incrimination. [CBS News, 6/14/2006] Sunderland himself received more than $600,000 in outside consulting and speaking fees from Pfizer from 1998 to 2004 without prior government disclosure or approval. A review by NIH’s Office of Management Assessment found that Sunderland "engaged in serious misconduct, in violation of HHS ethics rules and Federal law and regulation," the report stated. In December 2006, Sunderland will accept a plea bargain in regards to his accepting payments from Pfizer (see December 11, 2006). [The Scientist, 6/14/2006]

An article published in the journal Health Affairs reports that on average nonprofit nursing homes and hospitals provide better quality service than those operating for a profit. The authors of the report, whose conclusions are based on a review of 162 studies comparing nonprofit and for-profit health care providers, found that the evidence suggests that nonprofit hospitals have lower mortality rates. Eight of the studies surveyed by the authors concluded that nonprofits have lower death rates while only one study reported that for-profits have lower mortality rates. The article also reports that non-profit hospitals have lower expenses on average. For nursing homes, the opposite is true. The review says that evidence suggests for-profits tend to mark their prices up to improve the bottom line. There is also evidence that they receive more complaints. Sixteen percent of all hospitals are for-profit, a five percent increase since the early 1990s. [Reuters, 1/21/2006]

The Congressional Committee on Government Reform ends a 15-month investigation aimed at assessing how the FDA is fulfilling its regulatory responsibilities. The committee’s report, based on thousands of pages of internal agency enforcement records, concludes that enforcement activity has dropped dramatically under the Bush administration. According to the review, the annual number of FDA warning letters fell 54 percent between 2000 and 2005, from 1,154 to 535, a 15-year low. Additionally, the number of seizures of mislabeled, defective, and dangerous products dropped by 44 percent. According to the investigation, there were at least 138 cases where the FDA ignored recommendations from agency field inspectors to take enforcement actions. [US Congress, 6/26/2006 ; New York Times, 6/27/2006] In letters written to the committee, experts voiced concern that the FDA is becoming less vigilant in its oversight duties. Dr. Jerry Avorn of the Harvard Medical School, wrote that there is “a growing laxity in FDA’s surveillance and enforcement procedures,” a “dangerous decline in regulatory vigilance,” and an “obvious unwillingness to move forward even on claims from its own field offices.” Avorn describes the FDA as “an agency unwilling to exert its regulatory authority in defense of the public’s health.” [Avorn, 6/26/2006 ] Dr. Michael Wilkes of the University of California, Davis, School of Medicine, says the FDA has “systematically ignored District Field Officers and regularly overridden their explicit and well documented concerns about drug safety and public health.” It “seems unable and unwilling to step in to protect the American public,” he adds. [Wilkes, 6/10/2006 ] Another problem identified during the committee’s review of the documents concerns the agency’s record keeping. In response to questions from the committee, officials said the FDA lacks a centralized case tracking system and does not maintain a record of the enforcement recommendations made by its district offices. As a result, the investigation had to rely on the personal recollection of field office employees. [US Congress, 6/26/2006 ]

Tenet Healthcare Corp., the country’s second largest hospital chain, agrees to a $900 million settlement with the Justice Department over allegations that it defrauded Medicare. In 2003, the company was charged with violating the False Claims Act. The government alleged that Tenet had billed for services not rendered, inflated reimbursable costs, and paid kickbacks to doctors for referrals. The company, which admits no guilt—only that it made billing “mistakes”—will pay $725 million over a four-year period to resolve the billing dispute and will forfeit its right to collect $175 million in Medicare payments for past services. Wall Street analysts had expected the amount to be well over a billion. [Reuters, 6/29/2006; US Department of Justice, 6/29/2006; Tenet Healthcare Corp., 6/29/2006 ]

A survey taken by 997 FDA scientists suggests a pervasive problem of low morale among agency employees, due in large part to political interference by appointees. Sixty-two percent of those who participated in the poll were senior scientists and almost a third had worked for the FDA for more than 15 years. The survey was conducted by the Union of Concerned Scientists and Public Employees for Environmental Responsibility (PEER). Seventeen percent said “FDA decision makers” had asked them on at least one occasion to modify conclusions in an FDA document for nonscientific reasons. More than 40 percent knew of situations where political appointees had interfered with FDA determinations or actions. Forty-seven percent knew of instances where “commercial interests” improperly engaged in efforts to modify FDA conclusions. Only 51 percent said they believe the FDA is effectively safeguarding public health. Forty percent said there were times they chose not to publicly express concerns for fear of retaliation. Almost 70 percent said the agency lacks the needed resources to fulfill its regulatory duties. Forty percent said morale is poor or extremely poor. Only 32 percent said they feel the FDA is moving in the right direction. [Union of Concerned Scientists, 7/20/2006 ; New Jersey Star-Ledger, 7/21/2006]

Democrats, who will have control of both houses when Congress reconvenes next year, say they intend to push for legislation that will lower drug prices and tighten regulation of the pharmaceutical industry. They want to encourage the development of more generic drugs, allow imported drugs from Canada, investigate drug pricing and advertising, repeal legislation that limits vaccine manufacturers’ liability, and give the government the authority to negotiate lower drug prices for people on Medicare. [New York Times, 11/24/2006; Associated Press, 11/24/2006] In response, the drug industry begins hiring lobbyists with Democratic connections, with the hope of preventing the passage of these initiatives (see After November 7, 2006).

Concerned about Democratic plans (see After November 7, 2006) to push for lower drug prices and tighter regulation of the pharmaceutical industry, drug companies begin communicating with Democrats and recruiting lobbyists with Democratic connections. [New York Times, 11/24/2006] Billy Tauzin, president of the drug lobbying organization Pharmaceutical Research and Manufacturers of America (PRMA), meets with Senator Byron L. Dorgan, a North Dakota Democrat who has spent six years pushing for legislation that would allow drug imports from Canada. [New York Times, 11/24/2006] Amgen, a biotechnology firm, retains George C. Crawford, a former chief of staff for Representative Nancy Pelosi (D-Ca), as a lobbyist. [New York Times, 11/24/2006] Merck hires Peter Rubin, a former aide to Representative Jim McDermott of Washington. [New York Times, 11/24/2006] Cephalon contracts Kim Zimmerman, a health policy aide to Senator Ben Nelson (D-Ne). [New York Times, 11/24/2006] The Biotechnology Industry Organization retains Paul T. Kim, a former aide to Senator Edward M. Kennedy (D-Ma) and Representative Henry A. Waxman (D-Ca). [New York Times, 11/24/2006] One unnamed medicare expert who works for House Democrats tells the New York Times in late November that he received three separate job offers in one day from the drug industry. [New York Times, 11/24/2006]

Oxfam publishes a report concluding that poor people in developing nations are dying needlessly because drug companies and the governments of certain wealthy nations are putting a higher priority on defending intellectual property rights than protecting human life. According to the report, the United States has used free-trade agreements and threats of sanctions to prevent countries from producing and distributing low-cost generic drugs in order to preserve the monopolies of large drug companies. Likewise, the drugs makers themselves are pushing countries to prevent the sale of cheaper drugs. “Pfizer is challenging the Philippines government in a bid to extend its monopoly on Norvasc, a [blood] pressure drug. Novartis is engaged in litigation in India to enforce a patent for Glivec, a cancer drug, which could save many lives if it were available at generic prices,” the Guardian reports. The Oxfam report says that efforts to block the poor’s access to affordable medicine undermines the five-year old Doha declaration, which sought to improve poor countries’ access to cheap drugs. “[R]ich countries have failed to honor their promises. Their record ranges from apathy and inaction to dogged determination to undermine the declaration’s spirit and intent. The US, at the behest of the pharmaceutical industry, is uniquely guilty of seeking ever higher levels of intellectual property protection in developing countries,” the report says. [Guardian, 11/14/2006; Oxfam, 11/14/2006 ]

At a Pharmaceutical Research and Manufacturers of America (PRMA) board meeting, top executives from two dozen drug companies meet to work on a strategy to prevent the incoming Democratically-controlled Congress from passing legislation that would lower drug prices and tighten regulation of the industry (see After November 7, 2006). Their top concern is a bill they expect Democrats to push that would allow the government to negotiate lower drug prices for millions of older Americans on Medicare. Lobbyists for the industry concede that it is probable that such legislation will be passed by the House. But they say they are determined to have it killed in the Senate. If their efforts fail, and the Senate does pass such a bill, the drug industry believes that President Bush would veto it and that the veto would be upheld by the remaining Republicans in the Senate. Among those attending the meeting are Kevin Sharer, chairman of Amgen; Jeffrey B. Kindler, chief executive of Pfizer; Sidney Taurel, chairman of Eli Lilly; and Richard T. Clark, chief executive of Merck. [New York Times, 11/24/2006]

Dr. Pearson “Trey” Sunderland. [Source: CreativityFound (.org)]Dr. Pearson “Trey” Sunderland III, a National Institute of Health (NIH) senior researcher on Alzheimer’s disease, pleads guilty to a federal charge that he committed a criminal conflict of interest. The charges stem from Sunderland’s contract with the pharmaceutical firm Pfizer as a paid consultant for work that overlapped his duties as a public servant. Sunderland is the first official in 14 years to be prosecuted for conflict of interest at NIH, an agency rocked in recent years by revelations of widespread financial ties to the drug industry. According to the original court filing, in early 1998, “Sunderland initiated negotiations with Pfizer, the pharmaceutical giant, to be paid as a consultant for his work on the same project” that he headed for NIH, a research project into Alzheimer’s disease. In June 2006, Sunderland was revealed to have engaged in a secret contract with Pfizer to supply thousands of samples of spinal fluid collected from Alzheimer’s patients at taxpayer expense and slated to be used in NIH research. Sunderland turned those samples over to Pfizer, which in turn used them to refine and market its drug Aricept, a leading prescription drug for treating the disease (see June 14, 2006). According to the original charging document filed with the court, in 1998 Sunderland approached Pfizer with a proposal that he be paid $25,000 a year for “consulting” with the firm, plus $2,500 every time he attended a one-day meeting with company representatives. Pfizer agreed. Later that same year, Sunderland set up another deal with Pfizer to be paid another $25,000 a year, according to prosecutors. The House Energy and Commerce Committee received little cooperation from NIH—Sunderland himself invoked his Fifth Amendment right against self-incrimination when called to testify before the committee in June 2006—but subpoeaned 21 drug manufacturers known to have paid NIH researchers. Sunderland’s history of payments from Pfizer, which he did not reveal to the NIH as required by law, were some of those discovered. After that information was revealed in 2004, NIH director Elias Zerhouni requested that the inspector general of the Department of Health and Human Services investigate the matter. Government researchers found that 44 researchers, including Sunderland, had off-the-books relationships with drug and biotech companies; many of those researchers were reprimanded and/or took early retirement. At the time of Sunderland’s contracts with Pfizer, NIH restrictions against public-private collaborations were far more lax than they are today. [Associated Press, 12/4/2006; Associated Press, 12/5/2006; Los Angeles Times, 12/5/2006; Washington Post, 12/5/2006]'Public Trust Has Been Violated' - Congressman John Dingell (D-MI) asks, “Will a criminal conviction for conflict of interest be enough to get someone fired from NIH?” Bart Stupak (D-MI) adds, “If the National Institutes of Health and Commissioned Corps fail to discipline Dr. Sunderland, even after criminal charges have been brought, we can only conclude that no one is being held accountable, the system is broken, and the public trust has been violated.” [Associated Press, 12/5/2006; Los Angeles Times, 12/5/2006] Committee member Tammy Baldwin (D-WI) says: “I found this story incredibly distressing because it is so important that people have confidence in the NIH. It is a pretty big move for people to donate human tissue to further scientific discovery. People have to have confidence that that decision… is treated with the utmost respect.” [Washington Post, 12/5/2006]Guilty Plea Avoids Jail Time - Sunderland pleads guilty to the charge under a plea agreement in which he admits to taking some $285,000 in “unauthorized” consulting fees from Pfizer as well as $15,000 in travel expense payments between 1998 and 2003. During the same period, he provided Pfizer with spinal-tap samples collected from hundreds of patients as part of a research collaboration approved by the NIH. He agrees to pay the government $300,000, perform 400 hours of community service, and serve two years’ probation. Sunderland faced up to a year in prison and a $100,000 fine, but avoided those penalties through his plea agreement. After the hearing, US Attorney Rod Rosenstein tells reporters that Sunderland’s actions constitute a breach of the public trust. [Los Angeles Times, 12/5/2006; Washington Post, 12/5/2006] According to NIH spokesman Don Ralbovsky, Sunderland remains an employee, working as a “special assistant and senior adviser” in a division that gives out grants; Rabolvsky refuses to comment on whether Sunderland faces termination procedures. The branch of NIH that Sunderland once headed, the Geriatric Psychiatry Branch, no longer exists, according to Ralbovsky. [Washington Post, 12/5/2006] One media report says Sunderland is planning to retire. [Associated Press, 12/4/2006] Sunderland will later become a doctor and director of the Alzheimer Research Center at the Albert Einstein College of Medicine in New York. [Lundbeck Institute, 12/11/2008]Pfizer Denies Wrongdoing - For its part, Pfizer maintains that it broke no laws and breached no ethics, saying in a statement: “We believe our actions complied with applicable laws and ethical standards. We are not aware of any allegation that we violated any law or regulation.” [Los Angeles Times, 12/5/2006; Washington Post, 12/5/2006; Los Angeles Times, 12/11/2006]

James Kopp, convicted of murdering abortion provider Dr. Barnett Slepian (see March 17-18, 2003), is found guilty of violating the FACE Act, which makes it a crime to deny access to women’s health clinics (see May 1994). Because of the severity of his violation, Kopp is sentenced to life in prison without parole. Assistant US Attorney Kathleen Mehltretter says in court filings: “The fact that the defendant has been convicted in New York State Court is irrelevant to this proceeding. The United States has the obligation and the right to enforce its criminal laws.” [Buffalo News, 1/7/2007; National Abortion Federation, 2010]

Sharon Eubanks. [Source: Washington Post]Justice Department prosecutors appointed by the Bush administration interfered in the landmark lawsuit against tobacco companies, says the leader of the prosecution team, Sharon Eubanks. Eubanks says that Bush loyalists in Attorney General Alberto Gonzales’s office began micromanaging the team’s strategy in the final weeks of the 2005 trial, to the detriment of the government’s claim that the industry had conspired to lie to US smokers. Eubanks says that a supervisor demanded that she and her trial team drop recommendations that tobacco executives be removed from their corporate positions as a possible penalty. He and two others instructed her to tell key witnesses to change their testimony and ordered her to read verbatim a closing argument they had rewritten for her. “The political people were pushing the buttons and ordering us to say what we said,” Eubanks says. “And because of that, we failed to zealously represent the interests of the American public.” Eubanks, a 22-year veteran at the Justice Department, says three political appointees were responsible for the last-minute shifts in the government’s tobacco case in June 2005: then-Associate Attorney General Robert McCallum, then-Assistant Attorney General Peter Keisler, and Keisler’s deputy at the time, Dan Meron. The sudden strategy change sparked an uproar in Congress, and led to an inquiry by the Justice Department. Government witnesses said they had been asked to change testimony, and one expert withdrew from the case. Government lawyers also announced that they were rolling back a proposed penalty against the industry from $130 billion to $10 billion. Justice Department officials say that there was no political meddling in the case, an assertion supported by the department’s Office of Professional Responsibility. Eubanks, who left the department in December 2005, has not spoken publicly about the case until now. She says she is now coming forward because she is concerned about what she calls the “overwhelming politicization” of the department demonstrated by the controversy over the firing of eight US attorneys. Lawyers from Justice’s civil rights division have made similar claims about being overruled by supervisors in the past. Eubanks says Congress should investigate the matter along with the US attorney firings. “Political interference is happening at Justice across the department,” she says. “When decisions are made now in the Bush attorney general’s office, politics is the primary consideration.… The rule of law goes out the window.” US District Judge Gladys Kessler ruled in August 2006 that tobacco companies violated civil racketeering laws by conspiring for decades to deceive the public about the dangers of their product. She ordered the companies to make major changes in the way cigarettes are marketed. But she said she could not order the monetary penalty proposed by the government. Matthew Myers of the Campaign for Tobacco-Free Kids was one of the witnesses whom Eubanks asked to change his testimony. Yesterday, he said he found her account to be “the only reasonable explanation” for what transpired. Eubanks says that she was particularly distressed when McCallum, Keisler, and Meron ordered her to read word for word a closing argument they had rewritten. The statement explained the validity of seeking a $10 billion penalty. “I couldn’t even look at the judge,” she says. [Washington Post, 3/22/2007]

In a 5-4 decision splitting the court between conservatives and moderate/liberal justices, the Supreme Court upholds the 2003 ban on so-called “partial-birth abortions.” The Court rules that the Partial Birth Abortion Ban Act does not violate a woman’s constitutional right to an abortion. [CBS News, 4/19/2007]

In a 93-1 vote, the US Senate passes the Food and Drug Administration Improvement Act of 2007 (H.R.2273), which grants the FDA broad new authority to monitor the safety of drugs after they are approved. It was based in part on the recommendations of a 2001 report by the Institute of Medicine (see September 22, 2001). The institute had been asked by the FDA to examine drug safety after it was revealed that the FDA and drugmaker Merck had permitted the drug Vioxx to stay on the market despite numerous indications that it increased patients’ risk of a heart attack. But the bill that is passed is much weaker than the original version, and ignores some of the institute’s most critical recommendations. A USA Today investigation will find that industry-friendly changes made to the bill were instigated by senators “who raised millions of dollars in campaign donations from pharmaceutical interests.” For example, 49 senators successfully defeated an effort that would have allowed US consumers to import lower-cost drugs from Canada and other industrialized countries. The senators who opposed the provision “received about $5 million from industry executives and political action committees since 2001—nearly three quarters of the industry donations to current members of the Senate,” USA Today found. Another factor contributing to the amendment’s failure was that President Bush said he would veto the bill if it permitted the imports. Also excised from the bill was language that would have give the FDA the authority to ban advertising of high-risk drugs for two years. This was one of the Institute of Medicine’s key recommendations. Senator Pat Roberts (R-Kan) argued that the change would restrict free speech. Drug interests have given Roberts $18,000 so far this year, and $66,000 since 2001. Sen. Judd Gregg (R-NH) was responsible for a change that reduced the agency’s power to require post-market safety studies. He insisted on limiting this authority so that the FDA could only target drugs when there’s evidence of harm. Gregg has received $168,500 from drug industry interests since 2001. The bill’s main sponsors—senators Edward Kennedy, (D-Mass) and Mike Enzi (R-Wyo)—agreed to water down a proposal that would have required all clinical drug studies be made public after meeting with industry officials. The senators agreed to change the language so that only studies submitted to the FDA would be available. Enzi and Kennedy have received $174,000 and $78,000, respectively, from drug interests since 2001. Amendments aimed at reducing industry conflicts of interest on FDA expert advisory panels were also stripped from the bill. One of those amendments would have made it more difficult for scientists to advise the FDA on drug approval applications from a company the scientist had received money from. Another would have required that FDA panels consist of no more than one member with financial ties to the drug industry. The Senate also rejected an amendment to establish an independent FDA office to monitor the safety of drugs after they are released on the market. The office that currently has this authority is the same one that approves new drugs, an arrangement that lawmakers and at least one FDA scientist (see November 18, 2004) believe is a conflict of interest. [WebMD Medical News, 5/9/2007; US Congress, 5/10/2007; USA Today, 5/14/2007]

The Commonwealth Fund, a private organization founded to improve America’s health care system, releases a study that finds the US spends more on health care than any nation on earth, yet “consistently underperforms on most dimensions of performance, relative to other countries.” The report is based on a number of surveys conducted with patients along with information from primary care physicians. “The US spends twice what the average industrialized country spends on health care but we’re clearly not getting value for the money,” says Commonwealth Fund president Karen Davis. Compared with Australia, Canada, Germany, New Zealand, and Britain, “the US health care system ranks last or next-to-last on five dimensions of a high-performance health system: quality, access, efficiency, equity, and healthy lives. The US is the only country in the study without universal health insurance coverage, partly accounting for its poor performance on access, equity, and health outcomes. The inclusion of physician survey data also shows the US lagging in adoption of information technology and use of nurses to improve care coordination for the chronically ill.” These findings are similar to those of studies conducted in 2004 and 2006. “The most notable way the US differs from other countries is the absence of universal health insurance coverage,” the study’s authors note. “Other nations ensure the accessibility of care through universal health insurance systems and through better ties between patients and the physician practices that serve as their long-term ‘medical home.’ It is not surprising, therefore, that the US substantially underperforms other countries on measures of access to care and equity in health care between populations with above-average and below-average incomes.” The study’s executive summary concludes: “For all countries, responses indicate room for improvement. Yet, the other five countries spend considerably less on health care per person and as a percent of gross domestic product than does the United States. These findings indicate that, from the perspectives of both physicians and patients, the US health care system could do much better in achieving better value for the nation’s substantial investment in health.” Britain receives the highest overall ranking in the study, followed by Germany, and then by New Zealand and Australia, which tie for third. Canada is placed fourth. [Commonwealth Fund, 5/15/2007; Agence France-Presse, 5/15/2007]

Wendell Potter, a senior health care executive with the insurance giant Cigna, visits a “health care exposition” in Wise, Virginia, not far from his home town. Potter is shocked at what he sees at the Wise County Fairgrounds. As he will later recall (see July 10, 2009), he assumed he would see booths set up for people to get their blood pressure checked and so forth. What he actually sees is doctors providing a range of care in livestock stalls and tents. Some patients are treated while lying on gurneys, under a rainy sky. “And I saw people lined up, standing in line or sitting in these long, long lines, waiting to get care,” he will later say. “People drove from South Carolina and Georgia and Kentucky, Tennessee—all over the region, because they knew that this was being done. A lot of them heard about it from word of mouth. There could have been people and probably were people that I had grown up with. They could have been people who grew up at the house down the road, in the house down the road from me. And that made it real to me.… It was absolutely stunning. It was like being hit by lightning. It was almost—what country am I in? I just—it just didn’t seem to be a possibility that I was in the United States. It was like a lightning bolt had hit me.” Potter will describe himself as “insulated” from the harsh reality of American health care before visiting the expo. “I had a great job. And I had a terrific office in a high-rise building in Philadelphia. I was insulated. I didn’t really see what was going on. I saw the data. I knew that 47 million people were uninsured, but I didn’t put faces with that number.… [W]hen you’re in the executive offices, when you’re getting prepared for a call with an analyst, in the financial medium, what you think about are the numbers. You don’t think about individual people. You think about the numbers, and whether or not you’re going to meet Wall Street’s expectations. That’s what you think about, at that level. And it helps to think that way. That’s why you—that enables you to stay there, if you don’t really think that you’re talking about and dealing with real human beings.” Potter finds it difficult to reconcile his executive lifestyle with relatives and neighbors being treated in livestock stalls. He will eventually resign his position with Cigna. [PBS, 7/10/2009]

In an op-ed, the New York Times calls the idea that the US has “the best health care system in the world,” as recently stated by President Bush, or provides “the best medical care in the world,” as recently stated by former New York City Mayor Rudolph Giulani, a “delusion.” “That may be true at many top medical centers,” the Times writes. “But the disturbing truth is that this country lags well behind other advanced nations in delivering timely and effective care.” The Times notes that in 2000, the World Health Organization (WHO) ranked the health care systems of 191 nations. France and Italy were first and second; the US came in 37th. The Times notes a more recent study by “the highly regarded Commonwealth Fund,” which “has pioneered in comparing the United States with other advanced nations through surveys of patients and doctors and analysis of other data”; the latest Commonwealth Fund study put the US last among six highly developed nations (see May 15, 2007). “Other comparative studies also put the United States in a relatively bad light,” the Times notes. Lack of Universal Coverage - Unlike every other major industrialized nation, the US does not provide universal health coverage. In the US, some 45 million people have no health insurance whatsoever, and millions more suffer with poor coverage. The Times writes, “Although the president has blithely said that these people can always get treatment in an emergency room, many studies have shown that people without insurance postpone treatment until a minor illness becomes worse, harming their own health and imposing greater costs.” Lack of Access - While citizens of foreign nations often face longer waits before they can see specialists or undergo elective surgery than do Americans in comparable situations, “[t]he real barriers here are the costs facing low-income people without insurance or with skimpy coverage.” However, “even Americans with above-average incomes find it more difficult than their counterparts abroad to get care on nights or weekends without going to an emergency room, and many report having to wait six days or more for an appointment with their own doctors.” Unfair Disparities - The dichotomy between the care provided to economically well-off Americans and their more economically challenged fellows is worse than in any other industrialized nation. “Americans with below-average incomes are much less likely than their counterparts in other industrialized nations to see a doctor when sick, to fill prescriptions, or to get needed tests and follow-up care.” Unhealthy Living - The US ranks last among 23 nations in its infant mortality rate—more American children die in infancy than in 22 other countries. “But the problem is much broader,” the Times continues. “We rank near the bottom in healthy life expectancy at age 60, and 15th among 19 countries in deaths from a wide range of illnesses that would not have been fatal if treated with timely and effective care. The good news is that we have done a better job than other industrialized nations in reducing smoking. The bad news is that our obesity epidemic is the worst in the world.” Varying Quality - The Commonwealth Fund study notes that the US ranks first in providing the correct care for a given condition, and does very well in providing preventative care to its citizens. But it does much worse in coordinating the care of chronically ill patients, in protecting the safety of patients, and in meeting the needs and preferences of patients. Overall, the quality of health care in the US is the lowest among the six nations profiled by the study. Varying Survival Rates - US citizens live longer than their foreign counterparts with breast cancer, and second-longest with cervical cancer and childhood leukemia. But US citizens rank last or next-to-last in life expectancy for patients with kidney transplants, liver transplants, colorectal cancer, circulatory diseases, respiratory diseases, diabetes, bronchitis, asthma, and emphysema. Poor Patient Satisfaction - Only 40 percent of Americans are satisfied with the nation’s health care system. Of 17 countries surveyed, the US comes in 14th. The US ranks first in negative public perceptions, with a third of Americans calling for a system-wide revamp of American health care. Poor Use of Information Technology - American health care providers are years behind their foreign counterparts in their use of information technology, electronic medical records, electronic prescriptions, and more. “This makes it harder to coordinate care, spot errors, and adhere to standard clinical guidelines,” the Times writes. Conclusion - “With health care emerging as a major issue in the presidential campaign and in Congress, it will be important to get beyond empty boasts that this country has ‘the best health care system in the world’ and turn instead to fixing its very real defects,” the Times concludes. “The main goal should be to reduce the huge number of uninsured, who are a major reason for our poor standing globally.… The world’s most powerful economy should be able to provide a health care system that really is the best.” [New York Times, 8/12/2007]

Larry Niven. [Source: Larry Niven]A group of science fiction writers calling themselves SIGMA is engaged in advising the Department of Homeland Security (DHS) on how to protect the nation. Undersecretary of Science and Technology Jay Cohen says he likes their unconventional thinking. Two of the approximately 24 members are right-wing libertarian authors Jerry Pournelle and Larry Niven, who have collaborated on a number of books as well as writing numerous novels and short stories on their own. One of Niven’s more controversial ideas is to help hospitals stem financial losses by spreading rumors in Spanish within the Latino community that emergency rooms are killing patients in order to harvest their organs for transplants. Niven believes the rumors would discourage Latinos from using the nation’s emergency rooms and thus ease the burden on hospitals. “The problem [of hospitals going broke] is hugely exaggerated by illegal aliens who aren’t going to pay for anything anyway,” Niven says. Pournelle asks, somewhat jokingly, “Do you know how politically incorrect you are?” Niven replies, “I know it may not be possible to use this solution, but it does work.” [National Defense Magazine, 2/28/2008] One blogger, apparently angered by Niven’s proposal, later writes that Niven’s idea comes from his “magical, mystical fictional universe where hospitals don’t have to treat rednecks who OD on meth, insurance companies aren’t inflating the cost of hospital care, under-regulated drug companies aren’t making massive profits, and uninsured children of hardworking parents don’t fall off skateboards.” [Mark Frauenfelder, 3/28/2008]

A federal judge dismisses a lawsuit seeking to halt sales of the so-called “morning-after” birth control pill, the only such drug available in the US without a prescription. In 2006, the FDA reversed its 2004 decision not to allow the drug to be sold over the counter (see May 6, 2004 and After) to anyone 18 years of age or older. The suit was brought by the Association of American Physicians and Surgeons and a number of anti-abortion and social conservative groups. The US District Court in the District of Columbia finds that the plaintiffs failed “to identify a single individual who has been harmed by Plan B’s OTC [over-the-counter] availability.” The ruling is widely considered to be a victory for advocates of reproductive rights. “They still don’t have any evidence in terms of why they think it is harmful,” says Janet Crepps of the Center for Reproductive Rights (CRR). “This is the right decision for women.” A lawsuit filed by the CRR to force OTC sales of the drug to girls under 18 is still pending (see April 22, 2009). [Reuters, 3/4/2008]

John LaBruzzo. [Source: Daniel Erath / Times-Picayune]Louisiana State Representative John LaBruzzo (R-Metarie) says he is considering a legislative proposal to offer poor women $1,000 to be sterilized. LaBruzzo says that poor people who receive government aid such as food stamps and publicly subsidized housing are reproducing at a faster rate than more affluent, better-educated people. Offering poor women money to have their fallopian tubes “tied” would lower their birth rates, LaBruzzo explains. “We’re on a train headed to the future and there’s a bridge out,” he says of what he calls potentially dangerous demographic trends. “And nobody wants to talk about it.… What I’m really studying is any and all possibilities that we can reduce the number of people that are going from generational welfare to generational welfare.” Such payments would be voluntary, he says, and might include other forms of birth control, including vasectomies for men. He would also consider tax incentives for college-educated, higher-income couples to have more children. LaBruzzo, who represents the same district that sent former Ku Klux Klan leader David Duke to the Louisiana State House in 1989, is receiving criticism that calls his proposal racist, sexist, unethical, and immoral. LaBruzzo counters that since more white people are on welfare than black people, his proposal is not targeting race. “It’s easy to say, ‘Oh, he’s a racist,’” LaBruzzo says. “The hard part is to sit down and think of some solutions.” LaBruzzo is opposed to abortion in any form, and describes his sterilization program proposal as providing poor people with better opportunities to avoid welfare, because they would have fewer children to feed and clothe. [New Orleans Times-Picayune, 9/23/2008]

During the year, a number of states enact over 77 laws and other measures that affect reproductive rights, a sharp upturn from the 33 enacted in 2008. Some of these laws restrict reproductive rights (see 2009), others protect and enhance them. Some of the latter are as follows: California, Iowa, and Minnesota refuse to enact cuts in funding family planning programs. Colorado, in a move designed to protect contraceptive services from state restrictions on abortion, adopts a law formally defining contraception as any method used to prevent a pregnancy from occurring. Georgia and Wisconsin expand Medicaid recipients’ access to contraception, joining 19 other states with similar mandates. Hawaii and North Carolina enact laws requiring that sex education provided in public schools be medically accurate and include a discussion of contraception; in all, 17 states require inclusion of contraception in sex education curricula. North Carolina also mandates abstinence-only education and a discussion of sexually transmitted diseases. Illinois, North Dakota, Utah, and Vermont expand access to STI (sexually transmitted infections) treatment and prevention. Oregon enacts a new law to reduce the incidence of HPV (human papillomavirus) infections, joining five other states with such legal mandates. Utah and Virginia adopt laws designed to expand access to emergency contraception to women who have been sexually assaulted. In all, 12 states have similar provisions. Wisconsin passes a law requiring private insurance plans to cover contraceptive services and supplies under most circumstances; 27 states mandate similar coverage. [Guttmacher Institute, 1/2010]

During the year, a number of states enact over 77 laws and other measures that affect reproductive rights, a sharp upturn from the 33 enacted in 2008. Some of these laws protect and enhance reproductive rights (see 2009), others restrict them. Some of the restrictive laws are as follows: Arizona adopts what the Guttmacher Institute calls “a massive omnibus measure that essentially revamps abortion policy in the state,” requiring in-person counseling, long waiting periods before a woman can legally seek an abortion, and new restrictions on minors seeking abortions; the measure restricts the performance of abortion procedures to physicians only and grants providers new rights to refuse to participate in abortion-related services. The new measure is shepherded through the state legislature by Governor Jan Brewer (R-AZ), a strong opponent of abortion rights. Many of the new measures are not in effect due to legal challenges. Eighteen other states attempt to enact measures relating to parental involvement in attempts by minors to seek abortions, but fail. Arizona, Kansas, North Dakota, and Ohio adopt laws requiring abortion providers to post signs informing women that they cannot be coerced into having abortions, and encouraging their clients to contact authorities or clinic staff if they feel they have been subjected to such pressure. Arizona and Arkansas adopt measures restricting so-called “partial-birth abortions” similar to a federal ban upheld by the Supreme Court in 2007 (see April 17, 2007). In all, 17 states have such restrictions. Utah tightens the availability of such late-term abortions in its laws. A measure that would have entirely banned “partial-birth abortions” and restricted other such procedures was vetoed in Kansas. Iowa, Maryland, and Minnesota continue existing prohibitions on public funding for abortion. Kansas and Nebraska enact laws requiring that women seeking abortions after 19 weeks’ gestation be given information on the availability of ultrasound procedures. In all, 16 states now have similar requirements on the books. Massachusetts, Michigan, Montana, and Washington enact substantial cuts in family planning programs. North Dakota enacts a law requiring women seeking abortions to be told that the procedure will “terminate the life of a whole, separate, and unique human being.” Similar provisions were enacted by the Kansas legislature, but vetoed by Governor Mark Parkinson (D-KS). Oklahoma enacts laws banning abortions for purposes of “sex selection,” and institutes what the Guttmacher Institute calls “intrusive abortion reporting requirements” that will result in making private information about women seeking abortions public (see November 1, 2009). Utah requires women seeking abortions to be provided with information on the purported ability of a fetus to feel pain, information many medical providers consider false. The state also institutes an “Abortion Litigation Trust Account” to cover the cost of defending the state against legal challenges filed against its anti-abortion laws. Tennessee joins six other states in restricting access to contraceptive services. Virginia authorizes the sale of license plates with the “Choose Life” slogan, and earmarks profits from the sale of those plates to fund “crisis pregnancy centers” (see April 2006) across the state. Twenty-one states now offer such license plates. [Guttmacher Institute, 1/2010]

The California Nurses Association (CNA) releases the results of a study which found “a national single-payer style health care reform system would provide a major stimulus for the US economy by creating 2.6 million new jobs, and infusing $317 billion in new business and public revenues, with another $100 billion in wages into the US economy.” The study was conducted by the Institute for Health & Socio-Economic Policy (IHSP), a “non-profit policy and research group” that is “the exclusive research arm of the California Nurses Association/National Nurses Organizing Committee.” In addition to the growth in jobs and revenues generated by covering the 47 million Americans who were uninsured as of 2006, the study also found that universal coverage “could be achieved for $63 billion beyond the current $2.1 trillion in direct health care spending,” according to the press release for the study, which also notes that this figure is “six times less than the federal bailout for CitiGroup, and less than half the federal bailout for AIG.” [CalNurses.org, 1/14/2009]

Media critic and columnist George Neumayr writes that the Democrats’ economic stimulus plan will include enforced abortions and euthanasia for less productive citizens. Neumayr calls this claim a once “astonishingly chilly and incomprehensible stretch [that] is now blandly stated liberal policy,” basing it on the Democrats’ plan to provide money to the states for “family planning.” Neumayr equates the funding, which would go for such initiatives as teaching teenagers about the use of condoms and measures to avoid sexually transmitted diseases, to the famous Jonathan Swift essay of 1729, “A Modest Proposal,” which satirically suggested that impoverished Irish families might sell their children to rich Englishmen for food. “Change a few of the words and it could be a Democratic Party policy paper,” Neumayr writes. “Swift suggested that 18th-century Ireland stimulate its economy by turning children into food for the wealthy. [House Speaker Nancy] Pelosi [D-CA] proposes stimulating the US economy by eliminating them. Other slumping countries, such as Russia and France, pay parents to have children; it looks like Obama’s America will pay parents to contracept or kill them. Perhaps the Freedom of Choice Act can also fall under the Pelosi ‘stimulus’ rationale. Why not? An America of shovels and scalpels will barrel into the future. Euthanasia is another shovel-ready job for Pelosi to assign to the states. Reducing health care costs under Obama’s plan, after all, counts as economic stimulus too. Controlling life, controlling death, controlling costs. It’s all stimulus in the Brave New World utopia to come.” Like a Washington Times editorial from months earlier (see November 23, 2008), Neumayr uses the term “final solution” for the Democrats’ economic proposal, the term for the Nazis’ World War II-era extermination of millions of Jews and other “undesirables.” He writes: “‘Unwanted’ children are immediately seen as an unspeakable burden. Pregnancy is a punishment, and fertility is little more than a disease. Pelosi’s gaffe illustrates the extent to which eugenics and economics merge in the liberal utilitarian mind.” “Malthus lives,” he says, referring to the 19th century scholar Thomas Robert Malthus, whose theories of ruthless natural selection predated Charles Darwin’s theories of evolution. Neumayr goes on to accuse “Hillary Clinton’s State Department” of preparing to set up programs of “people-elimination,” predicated on what he calls “UN-style population control ideology” and “third-world abortions.” [American Spectator, 1/27/2009]

Betsy McCaughey (R-NY), the former lieutenant governor of New York and a fellow at the conservative Hudson Institute, writes that health care provisions in the Obama administration’s economic stimulus plan will affect “every individual in the United States.” McCaughey writes: “Your medical treatments will be tracked electronically by a federal system. Having electronic medical records at your fingertips, easily transferred to a hospital, is beneficial. It will help avoid duplicate tests and errors. But the bill goes further. One new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and ‘guide’ your doctor’s decisions.” McCaughey says the provisions are similar to suggestions in the book Critical: What We Can Do About the Health Care Crisis, by former Senate Majority Leader Tom Daschle (D-SD), until recently Obama’s pick to head the Department of Health and Human Services. McCaughey writes that hospitals and doctors who do not use the system will be punished, by a federal oversight board to be called the Federal Coordinating Council for Comparative Effectiveness Research. Perhaps most worrisome is McCaughey’s claim that elderly Americans will be given reduced health care based on their age and expected productivity. “Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost-effectiveness standard set by the Federal Council,” she writes. “The Federal Council is modeled after a UK board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis. In 2006, a UK health board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye. It took almost three years of public protests before the board reversed its decision.… If the Obama administration’s economic stimulus bill passes the Senate in its current form, seniors in the US will face similar rationing. Defenders of the system say that individuals benefit in younger years and sacrifice later. The stimulus bill will affect every part of health care, from medical and nursing education, to how patients are treated and how much hospitals get paid. The bill allocates more funding for this bureaucracy than for the Army, Navy, Marines, and Air Force combined.” [Bloomberg News, 2/9/2009] McCaughey’s claims are very similar to the ones she made against the Clinton administration’s attempt to reform health care in 1994 (see Mid-January - February 4, 1994). They will be proven false (see July 23, 2009).

Fox News graphic making disproven claims about Congressional health care reform proposals. [Source: Media Matters]The Wall Street Journal, Fox News anchors, conservative Web news purveyor Matt Drudge, and conservative radio host Rush Limbaugh promulgate a discredited claim by health care lobbyist Betsy McCaughey that the economic recovery bill pending in Congress includes a provision that would have the government “essentially dictate treatments” for sick Americans. McCaughey wrote a commentary for Bloomberg News on February 9 that makes the claim (see February 9, 2009); Drudge and Limbaugh echo and add to the claim the same day. The next day, the Wall Street Journal’s senior economic writer, Stephen Moore, appearing on Fox News’s flagship morning news broadcast America’s Newsroom, joins news anchors Bill Hemmer and Megyn Kelly in promoting the same claim (see October 13, 2009), with Moore saying that the provision would “hav[e] the government essentially dictate treatments.” Moore credits Limbaugh with informing him of the claim, saying: “I just learned of this myself yesterday. In fact, Rush Limbaugh made a big deal out of it on his radio show and it just—it caused all sorts of calls into congressional offices.” On February 10, Limbaugh takes credit for spreading the claim, telling listeners: “Betsy McCaughey writing at Bloomberg, I found it. I detailed it for you, and now it’s all over mainstream media. Well, it’s—it headlined Drudge for a while last night and today. Fox News is talking about it.” McCaughey is wrong in the claim: according to an analysis of the legislative language by progressive media watchdog Media Matters, “the language in the House bill that McCaughey referenced does not establish authority to ‘monitor treatments’ or restrict what ‘your doctor is doing’ with regard to patient care but, rather, addresses establishing an electronic records system such that doctors would have complete, accurate information about their patients ‘to help guide medical decisions at the time and place of care.’” Moore says: “[T]his news story really has exploded on the public scene in just the last 24 hours, Bill. We’ve been just inundated with complaints from people about the implications of having the government essentially dictate treatments.” Moore later goes on to add that the bill “especially will affect elderly people, because one of the ways, if we move more towards a nationalized health care system, as this bill would move us one step towards that, what you have to do to restrain costs—what many other countries do, like Canada and Britain, is they essentially, Bill, ration care. And they tell patients you are eligible for this kind of care, but this is too expensive. And so what this bill would essentially do is set up a kind of pricing mechanism to tell people, yes, we can afford to treat you for this, but not that.” Moore encourages viewers to “express their outrage over this” before Congress takes the issue up. Kelly adds another false claim: that the bill discourages doctors to act on their own judgment and promotes medical decisions “in the spirit of uniform health care.” Kelly notes, “That sounds dangerously like socialized medicine.” Hemmer also makes the false claim that the legislation contains “rules [that] appear to set the stage for health care rationing for seniors, new limits on medical research, and new rules guiding decisions your doctor can make about your health care.” Hemmer calls the provision a “midnight health care insertion” into the Senate spending bill. [Media Matters, 2/10/2009]

The Washington Times spins off a recent op-ed by health industry lobbyist Betsy McCaughey (see February 9, 2009) to claim that the Obama administration will attempt to save money by euthanizing old people, disabled people, and sickly infants. The editorial begins with the “chilling” idea of a national medical information database that will allow the government to “track… your every visit to a health care provider—where you went, who you saw, what was diagnosed, and what care was provided.” The Obama administration, the Times claims, will use that information to decide which people deserve the more expensive lifesaving treatments and which ones must be denied in the interest of cost efficiency. “If it costs too much to treat you, and you are nearing the end of your life anyway, you may have to do with less, or with nothing,” the Times writes. “You just aren’t worth the cost.… What nondescript GS-11 will be cutting care from Aunt Sophie after her sudden relapse before he or she heads to the food court for some stir fry?” The elderly, the physically and mentally disabled, all “whose health costs are great and whose ability to work productively in the future” will, the Times writes, be allowed to die or even exterminated. So will premature babies, badly wounded soldiers, and others as yet to be determined. The Times again cites Nazi Germany’s “T4 Aktion” program of forcibly euthanizing less productive citizens (see November 23, 2008) as a likely template for the Obama program. [Washington Times, 2/11/2009]

Conservative syndicated columnist Cal Thomas uses a recent editorial by health care industry lobbyist Betsy McCaughey (see February 9, 2009) to accuse the Obama administration of planning a “euthanasia” program to exterminate hapless Americans. President Obama’s economic stimulus plan, Thomas writes, “means the government will decide who gets life-saving treatment and who doesn’t. It is survival of the fittest in practice.” Thomas then writes that the Obama administration’s support of legal abortions will inevitably lead to “euthanasia” of older and less productive citizens. He quotes a 1979 book by theologian Francis Schaeffer and future Surgeon General C. Everett Koop, Whatever Happened to the Human Race? as saying, “Will a society which has assumed the right to kill infants in the womb—because they are unwanted, imperfect, or merely inconvenient—have difficulty in assuming the right to kill other human beings, especially older adults who are judged unwanted, deemed imperfect physically or mentally, or considered a possible social nuisance?” Thomas then writes, “No one should be surprised at the coming embrace of euthanasia.” Schaeffer and Koop’s prediction that “the next candidates for arbitrary reclassification as nonpersons are the elderly” now “seems to be coming true,” Thomas writes. He also repeats a claim from the 92-year-old Koop that in 1988, he had suffered from an ailment that temporarily paralyzed him. Under Britain’s government-run health care, Koop claims, “I would have been nine years too old to have the surgery that saved my life and gave me another 21 years.” Soon, Thomas writes, “dying will become a patriotic duty when the patient’s balance sheet shows a deficit.” [Tribune Media Services, 2/18/2009]

Dave Schultheis. [Source: NowPublic (.com)]Colorado Republican State Senator Dave Schultheis votes against a bill requiring pregnant women to be tested for HIV so their unborn children can be treated to prevent the virus’s transfer. Instead, Schultheis says the babies should be allowed to have HIV so as to punish the mother’s actions. “This [HIV] stems from sexual promiscuity for the most part, and I just can’t go there,” he says. “We do things continually to remove the consequences of poor behavior, unacceptable behavior, quite frankly. I’m not convinced that part of the role of government should be to protect individuals from the negative consequences of their actions.” Lois Tochtrop, a Democratic Senator who co-sponsored the bill, replies: “HIV does not just come from sexual promiscuity. It comes from many other things, contaminated blood for one.” Fellow Democrat Jennifer Veiga calls Schultheis’s comments “shameful.” Minority Leader Josh Penry, the leader of the Senate Republicans, says he has no intention of muzzling the members of his caucus, though he says he has reminded his colleagues “we should never lose sight of the humanity of people on the other side of an issue.” Penry accuses Senate Democrats of attempting to “gin up the outrage machine,” and says Democrats have made their share of questionable comments. The bill in question has the support of every Senate Republican except Schultheis; Penry is a co-sponsor. Schultheis’s is the only “no” vote. House member Marsha Looper is one of the few Republicans to question Schultheis’s comments, and the Senate Republican leadership’s failure to publicly criticize his remarks. “What are they doing over there?” she asks. “I find their comments inappropriate and offensive, and I question their motives.” Former Governor Bill Owens, a Republican, says he cannot understand Schultheis’s vote: “It’s extremely inconsistent for any person who is pro-life to oppose this effort to potentially save the life of a child.” For his part, Schultheis answers Democratic criticism by making further comments which many find even more offensive. “What I’m hoping is that yes, that person may have AIDS, have it seriously as a baby and when they grow up, but the mother will begin to feel guilt as a result of that,’ he says. “The family will see the negative consequences of that promiscuity and it may make a number of people over the coming years… begin to realize that there are negative consequences and maybe they should adjust their behavior. We can’t keep people from being raped. We can’t keep people from shooting each other. We can’t keep people from jumping off bridges. People drink and drive, and they crash and kill people. Poor behavior has its consequences.” [Rocky Mountain News, 2/25/2009; Denver Post, 2/26/2009]

The Department of Health and Human Services rescinds the controversial “conscience rule” that allows health care workers to refuse to provide abortion counseling or other family-planning services if doing so would violate their moral or religious beliefs. The rule was announced on December 19, 2008 as one of the Bush administration’s final policy initiatives. Seven states have already challenged the rule in court, arguing that it sacrifices the health of patients to religious beliefs of medical providers. The American College of Obstetrics and Gynecology has reported numerous cases regarding the rule, including a Virginia mother of two who became pregnant after being denied emergency contraception, and a rape victim whose prescription for emergency contraception was rejected by a pharmacist. Obama officials say the administration will consider drafting a new rule to clarify what health care workers can reasonably refuse for patients. The public has 30 days to respond to the move before it becomes viable. Sister Carol Keehan, president of the Catholic Health Association, said in December that her organization supported the rule because in recent years “we have seen a variety of efforts to force Catholic and other health care providers to perform or refer for abortions and sterilizations.” However, opponents of the rule, including the American Medical Association, the National Association of Chain Drug Stores, and Planned Parenthood, said it could have voided state laws requiring insurance plans to cover contraceptives and requiring hospitals to offer emergency contraception to rape victims. It could also allow drugstore employees to refuse to fill prescriptions for contraceptives. And the Civil Rights Act of 1964 already offers broad protection against discrimination based on religion, mandating that an employer must make reasonable accommodations for an employee’s practices and beliefs. Cecile Richards of Planned Parenthood says, “Today’s action by the Obama administration demonstrates that this president is not going to stand by and let women’s health be placed in jeopardy.” [Chicago Tribune, 2/27/2009; New York Times, 2/27/2009]

According to media reports, the Obama administration intends to reverse the “right of conscience rule,” formally called the Provider Refusal Rule, for health care workers enacted by President Bush in the last weeks of his term. In December 2008, Bush issued an executive order allowing health care workers to deny care based on their personal beliefs. The order was issued to target doctors and nurses who do not want to provide abortions, even if they work in a facility that offers abortions to clients. Specifically, the rule denies Department of Health and Human Services (HHS) funding to institutions that do not allow workers to refuse care that goes against their beliefs. Now the Obama administration says President Obama will override that order. Seven states have already challenged the rule, claiming it sacrifices the health of patients in order to satisfy the religious or moral beliefs of medical personnel. The American College of Obstetrics and Gynecology has reported cases such as that of a Virginia mother of two who became pregnant because she was denied emergency contraception; in Texas, the group said, a rape victim had her prescription for emergency contraception rejected by a pharmacist. Obama has already overturned a ban on US funding for international aid groups that provide abortion services. However, administration officials say the administration may consider a rule that would clarify what health care workers can reasonably refuse. An HHS spokesman says: “We recognize and understand that some providers have objections to providing abortions. But we do not want to impose new limitations on services that would allow providers to refuse to provide to women and their families services like family planning and contraception that would actually help prevent the need for an abortion in the first place.” Dr. Suzanne Poppema of Physicians for Reproductive Choice and Health praises Obama “for placing good health care above ideological demands,” and says: “Physicians across the country were outraged when the Bush administration, in its final days, limited women’s access to reproductive health care. Hundreds of doctors protested these midnight regulations and urged President Obama to repeal them quickly. We are thrilled that President Obama took the first steps today to ensure that our patients’ health is once again protected.” Tony Perkins of the anti-abortion Family Research Council (FRC) counters: “Protecting the right of all health care providers to make professional judgments based on moral convictions and ethical standards is foundational to federal law and is necessary to ensure that access to health care is not diminished, which will occur if health care workers are forced out of their jobs because of their ethical stances. President Obama’s intention to change the language of these protections would result in the government becoming the conscience and not the individual. It is a person’s right to exercise their moral judgment, not the government’s to decide it for them.” [Chicago Tribune, 2/27/2009; CNN, 2/27/2009; New York Times, 2/27/2009] The liberal Center for American Progress (CAP) writes in April 2009: “Conservatives have criticized the Obama administration for infringing upon the conscience of health care professionals and ‘forcing’ them to provide abortion services.… Yet this assertion could not be further from the truth. President Obama’s proposal to rescind Bush’s last-minute rule restores the pre-existing compromise established through decades of debate.” CAP notes that Title VII of the Civil Rights Act disallows employers from firing or harassing workers who decline to fulfill assigned tasks due to moral or religious objections. “Obama’s proposal to rescind the Bush ‘conscience’ rule simply restores the prior balance that existed on matters of conscience,” CAP concludes. “It once again guides the health care system to value the consciences of health care providers and patients.” [Jessica Arons and Sarah Dreier, 4/28/2009] However, for reasons never made publicly clear, the Obama administration will never actually rescind the order. It is possible that Obama or HHS officials bow to pressure from a number of organizations such as the FRC and the Christian Medical Association, which have continually pressured the administration not to rescind the order. [Fox News, 4/8/2009; Time, 2/4/2010; Megan Sullivan, 7/13/2010]

Samantha Burton, a 25-year-old Florida resident in the 25th week of her pregnancy, is told by her doctor that she is at risk of miscarrying her child. The doctor orders her to immediately undertake a program of bed rest. Burton disagrees, saying that as a working mother with two children already, she cannot afford to miss work. She asks for a second opinion. Instead, her doctor informs Florida authorities; the Circuit Court of Leon County summarily forces Burton to be admitted to Tallahassee Memorial Hospital against her will and orders that she undergo whatever procedure her doctor orders. Burton is granted no legal representation in the decision; the forcible hospitalization is imposed after a single telephone “hearing” without a review of her medical records. Burton requests that she be moved to a different hospital, a request denied by the court, which rules that “such a change is not in the child’s best interest at this time.” Three days into her forced hospitalization, Burton is forced to submit to an emergency C-section, at which time her fetus is found to have died. [New York Times, 1/12/2010; Diana Kasdan, 1/13/2010; Roxann MtJoy, 1/15/2010] The American College of Obstetricians and Gynecologists says that such a prescription of enforced bed rest does nothing to help prevent miscarriage and premature birth, and does not recommend it. [BabyCenter (.com), 1/2010] Burton, along with the Florida chapter of the American Civil Liberties Union (ACLU), sues the State of Florida, claiming that Florida violated her constitutional rights. Burton and the ACLU argue, “To ignore this fundamental constitutional distinction between the state interest in protecting fetal life and its interest in the protecting the lives and health of people is to risk virtually unfettered intrusion into the lives of pregnant women.” Instead, the court rules against Burton, finding that Florida was merely maintaining what it calls the “status quo,” and that it was forced to intervene in what it calls an “extraordinary” situation. Burton appeals the decision. [New York Times, 1/12/2010; Roxann MtJoy, 1/15/2010] The ACLU’s Diana Kasdan writes that the court’s intervention denies Burton “her fundamental right to make her own informed decisions about medical care during her pregnancy.… It is hard to imagine any worse approach to helping pregnant women have safe pregnancies and healthy newborns than the one used by the State of Florida in Ms. Burton’s case.” [Diana Kasdan, 1/13/2010]

Washington Post columnist Greg Sargent writes that the current Republican plan of “total obstructionism” towards the Obama administration’s economic policies echoes the Republicans’ 1993 efforts to defeat the Clinton administration’s health care program (see December 2, 1993). In 1993, Republican pundit William Kristol warned that if the health care plan were successful and indeed improved the lives of Americans, the damage to the Republican Party’s image and ideology would be severe. Therefore, even though, according to Sargent, the plan stood an excellent chance of improving the US health care system, it had to be defeated. Sargent writes that today’s Republican opposition to President Obama’s economic plans “echo… the strategic objectives Kristol articulated 15 years ago.” Unfortunately, the Republican Party is far worse off “now than it was then in terms of being able to achieve those objectives.… Fifteen years later, of course, political conditions are dramatically different. Polls show the public broadly supports a far more activist role for government and backs Obama’s plans to expand the federal government’s role in a way not seen in decades. And it’s conservative ideas that are in retreat. Yet the GOP is pursuing roughly the same strategy today that it did then.” [Plum Line, 3/2/2009]

Pie chart showing the focus of New York State’s stem cell research. [Source: New York State Stem Cell Science]President Obama lifts restrictions on federal funding for research on new stem cell lines. Promising to “vigorously support” new research, Obama’s decision reverses the Bush administration’s policy of blocking government spending for researching human embroynic stem cell lines created after August 9, 2001. “When it comes to stem cell research, rather than furthering discovery, our government has forced into what I believe is a false choice between sound science and moral values,” Obama says during the signing ceremony. “In this case, I believe the two are not inconsistent. As a person of faith, I believe we are called to care for each other and work to ease human suffering.” Obama says the decision authorizes the change “so many scientists and researchers and doctors and innovators, patients and loved ones have hoped for and fought for these past eight years.” Scientists say the new research will lead to a variety of medical breakthroughs, and polls show most Americans support the research. Some religious and social conservative groups oppose the research, as does the Vatican. Obama promises that the government will never fund research into human cloning or other such controversial areas of study. Using discarded embryos for stem cell research is routine in private clinics, but illegal under Bush’s 2001 executive order. Analysts say that the policy change is part of Obama’s pledge to make clear that his administration wants scientific research to be free from political interference. [BBC, 3/9/2009; Guardian, 3/10/2009]Praise for Decision - The co-director of Harvard University’s stem cell research institute, Doug Melton, says: “It is a relief to know that we can now collaborate openly and freely with other scientists in our own university and elsewhere, without restrictions on what equipment, data, or ideas can be shared.… Science thrives when there is an open and collaborative exchange, not when there are artificial barriers, silos, constructed by the government.” Harvard spokesman B. D. Colen says that the practical effects of the Obama reversal will be dramatic: “This will mean the end of the quite onerous bookkeeping and segregation of supplies, equipment, and people that were necessary under the Bush executive order,” he says. “Literally, you could not pick up a pencil off a bench if you were working with embryonic stem cells.” [Guardian, 3/10/2009] Peter Wilderotter, president of the Christopher and Dana Foundation, praises Obama for “removing politics from science” and freeing researchers. Wilderotter leads a foundation created by actor Christopher Reeve, whose fall from a horse paralyzed him and led him to die at a relatively early age. Reeve believed that stem cell research could find a treatment for his condition. Obama says that Reeve dreamed of being able to walk again, and adds: “Christopher did not get that chance. But if we pursue this research, maybe one day—maybe not in our lifetime, or even in our children’s lifetime—but maybe one day, others like him might.” [BBC, 3/9/2009; Guardian, 3/10/2009]Republican Criticism - House Minority Leader John Boehner (R-OH) decries the decision, and accuses Obama of undermining “protections for innocent life, further dividing our nation at a time when we need greater unity to tackle the challenges before us.” Political correspondent and pundit Chris Cillizza writes: “The stem cell signing—like the economic stimulus bill—is an example of the two different tracks that Obama and Republicans are currently on. Obama, with his base solidly on his side, is making policy with broad support among independents. Republicans, on the other hand, remain in the wilderness and are looking to rebuild from core principles.” [BBC, 3/9/2009]

Dr. George Tiller, one of three doctors in the US that perform late-term abortions, is acquitted of misdemeanor charges that he violated laws governing such abortions. Within minutes of the acquittal, the Kansas Board of Healing Arts announces that it is investigating allegations against Tiller almost identical to the charges rejected by the jury. Prosecutors alleged that in 2003, Tiller had gotten second opinions on late-term abortions, not from an independent doctor as required by law, but from a doctor that was an employee of his. The jury takes an hour to reject the 19 charges. “You would hope it would be over,” says Tiller’s attorney Dan Monnat, “but there is a group of people who want to suppress the constitutional rights of women.” Tiller has maintained that the charges are politically motivated. He has long been a target of violent anti-abortion protests; his clinic was bombed in 1985 and targeted by the 1991 “Summer of Mercy” protests featuring violent demonstrations, and in 1993 he was shot by an anti-abortion activist (see August 19, 1993). [Associated Press, 3/27/2009] Tiller will be murdered by anti-abortion activist Scott Roeder several weeks later (see May 31, 2009).

FreedomWorks logo. [Source: FreedomWorks]The progressive news and advocacy site Think Progress profiles FreedomWorks, a conservative lobbying firm that uses the practice of “astroturfing” to press its agenda home. FreedomWorks is one of the organizations behind the anti-tax “tea party” movement (see April 8, 2009). The organization denies that it is “astroturfing”—creating fake “citizens groups” that purport to be spontaneously organized grassroots organizations—and compares its work to that of liberal activism group MoveOn.org. However, Think Progress notes that MoveOn is a citizen-organized group, while FreedomWorks is headed by former Republican activists and corporate officials, and is funded by oil, energy, and tobacco companies. Former House Majority Leader Dick Armey and current Washington lobbyist (R-TX) leads FreedomWorks. [Think Progress, 4/14/2009]'Amateur-Looking' Astroturfing Sites - Last year, the Wall Street Journal exposed FreedomWorks’ use of “amateur-looking” Web sites for its “astroturf” groups to bolster their credibility as purported “citizen groups” pushing for corporate interests (see May 16, 2008). [Think Progress, 4/14/2009]Represented by PR Firm with GOP Links - FreedomWorks is represented by the Washington public relations firm Shirley & Banister Public Affairs. Shirley & Banister also represents conservative organizations such as the National Rifle Association, Citizens United, news outlet Human Events, and organizer Richard Viguerie’s direct-mail firm. (It also represents the Bradley Foundation, a conservative funding organization that in 2008 gave $25,000 to both FreedomWorks and Americans for Prosperity [AFP], gave FreedomWorks $75,000 in 2009, and is considering a grant request from AFP.) One of Shirley & Banister’s partners is Craig Shirley, a veteran Republican PR operative who helped develop the overtly racist 1988 “Willie Horton” political ad (see September 21 - October 4, 1988). Progressive MSNBC host Rachel Maddow tells her audience: “This is a perfect system for the Republican Party. It’s a constant feedback loop. The Republican Party activists stir up fear and anger on the Internet… Fearful, angry people go to town hall events and then Republican Party officials say they are just responding to that anger and they have no idea where it came from. It’s [a] perfect cycle. Rile them up with made-up stuff and then sympathize with them that are so riled.” [MSNBC, 8/14/2009; MSNBC, 8/17/2009]Led by Millionaires - Three of FreedomWorks’ most prominent senior officials are millionaires. Armey makes over $500,000 a year working for the organization, and lives in a Texas home valued at $1.7 million. FreedomWorks president Matthew Kibbe lives on Capitol Hill in Washington, DC, in a home valued at $1.17 million. Board member Steve Forbes, the billionaire publisher of Forbes magazine, lives in a New Jersey home valued at $2.78 million, owns a chateau in France, and recently sold a private island in Fiji and a palace in Morocco. [Wall Street Journal, 5/16/2008]FreedomWorks Supports Armey's Lobbying Efforts - Armey’s lobbying firm, DLA Piper, represents pharmaceutical firms such as Bristol-Myers Squibb, medical device supplier SleepMed, health care provider Metropolitan Health Networks, and another pharmaceutical firm, Medicines Company. One member of FreedomWorks’s board of directors is Richard Stephenson, the founder and chairman of Cancer Treatment Centers of America. He is also the president of International Capital and Management Company, which runs a hospital consulting company. The president of FreedomWorks is Matt Kibbe, the former senior economist for the Republican National Committee and the former chief of staff for Representative Dan Miller (R-FL). FreedomWorks is organizing protests against health care reform that would cut into pharmaceutical firms’ profits. DLA Piper represents a number of life insurance firms; FreedomWorks has organized support for the deregulation of the insurance industry. DLA Piper represents not only several American oil firms, but also Sheikh Mohammed Bin Rashid Al Maktoum, prime minister of the United Arab Emirates (UAE), on energy related issues such as maintaining the close ties between the US and the UAE. US oil firms are deeply involved in the UAE’s oil industry. [Center for Responsive Politics, 2009; Think Progress, 4/14/2009; MSNBC, 8/12/2009] In August 2009, after reporting on FreedomWorks, MSNBC host Rachel Maddow will tell her audience: “Washington lobbyists and health care executives and former Republican Party officials have just as much a right to shout down the policy debate about health care reform as anyone else does. These folks have just as much a right to try to derail this entire process as anyone else does. But we have a right to know who they are and who is paying them for their efforts. These guys are pros. This is an industry. This is beltway politics being organized and played out in town halls across the country.” [MSNBC, 8/12/2009] DLA Piper has also received $830,000 this year, so far, from the pharmaceutical firm Medicines Company; the same firm paid DLA Piper $1.5 million in 2008. [MSNBC, 8/7/2009]FreedomWorks Lobbying on Behalf of DLA Piper? - In August 2009, Maddow will ask, “[W]hy are DLA Piper’s clients relevant?” She answers herself, “There appears to be some pretty good evidence that when you pay Dick Armey’s lobbying firm, DLA Piper, you get what Dick Armey’s grassroots organization FreedomWorks does.” In the first half of 2007, the American Council of Life Insurers paid DLA Piper $100,000 to lobby on its behalf. During that time span, FreedomWorks began lobbying Congress on a “grassroots” basis to deregulate the life insurance industry. Maddow will sarcastically ask: “And, of course, perhaps it is just mere coincidence that FreedomWorks happened to have a newfound, ideological, purist grassroots commitment to life insurance deregulation at the same time the American Council of Life Insurers hired Dick Armey’s lobbying firm. It could just be a coincidence. Could be, right?” In 2006, DLA Piper began lobbying for the Senado de Republica, the Mexican Senate, for the purpose of “enhancing US-Mexico relations.” At the same time, FreedomWorks began promoting itself as “one of the few organizations willing to aggressively promote meaningful immigration reform.” In 2004, during the Bush administration’s push to privatize Social Security, a single mom from Iowa was introduced at a White House economic conference as a supporter of privatization. That mom was a FreedomWorks employee. Maddow will say: “This is how FreedomWorks does their work. They try to create the impression that their just regular grassroots Americans without any financial or political interests in the outcome of these policy fights.” [MSNBC, 8/12/2009]

The Senate Finance Committee, chaired by Senator Max Baucus (D-MT), holds a series of hearings about health care reform, on April 21, May 5, and May 12. In all, 41 experts testify, but none of them advocate the so-called “single-payer” form of health care, a system which essentially has the government providing health care insurance instead of private insurers—“Medicare for all Americans,” as some characterize it. [Politico, 5/5/2009; Single Payer Action, 5/21/2009] The experts are from organizations like America’s Health Insurance Plans (AHIP), the health industry’s largest lobbying firm, and health insurers Blue Cross and Aetna. Some of the invited organizations employ former Baucus staff members. [Rolling Stone, 9/3/2009] Baucus says that single-payer is “off the table,” and will not be considered. [TPM Cafe, 5/5/2009]Health Industry Heavy Donors to Baucus - The nonpartisan organization Consumer Watchdog has reported that Baucus, one of the Senate’s most important architects of Congressional health reform, has accepted more campaign contributions from the health insurance and pharmaceutical corporations than any other current Democratic member of the House or Senate. During the last two election cycles, he received $183,750 from health insurance companies and $229,020 from drug companies. [Single Payer Action, 5/21/2009]Protesters Disrupt Hearings - Protesters disrupt the hearings by standing up and shouting criticisms of the committee over its failure to bring single-payer into the discussion. Eight protesters are led out of the hearing room and later arrested. At one point, Baucus asks for more police officers to enforce security. The protests are organized by Healthcare Now, Physicians for a National Health Program, and Single Payer Action, all of whom support a single-payer, government-run health care system. One protester calls the hearings nothing more than “political theater.” For his part, Baucus assures the audience, “I want you to know I care deeply about your views.” [Politico, 5/5/2009] The eight protesters spend around seven hours in jail. One, Dr. Margaret Flowers, later recalls: “It’s funny, the policemen were all telling us their horror stories about health care. One was telling us about his mother who was 62 and lost her job and was uninsured, waiting to get Medicare when she was 65.” The protesters are sentenced to six months’ probation. Baucus later admits that not allowing single-payer advocates to participate in the hearings was a mistake; he will eventually agree to meet with a group of those advocates (see June 3, 2009). Single-Payer Never Considered - In September, Rolling Stone reporter Matt Taibbi will note that Baucus, like President Obama and other prominent Democrats, has supported single-payer insurance in theory, but asserts such a proposal would never get through Congress. Journalist Russell Mokhiber, who advocates for single-payer as a member of Single Payer Action, later says that the Obama administration and Congressional Democrats made an agreement with health industry leaders months before considering legislation for health care reform that single-payer would not be part of their proposals. In return, Mokhiber will say, they asked the industry not to oppose their reform efforts, a request that the industry has generally not honored. [Rolling Stone, 9/3/2009]

The Food and Drug Administration (FDA) announces that, in line with a judge’s recent ruling, it will approve the sale of the so-called “morning-after” emergency contraception pill to 17-year olds without a doctor’s prescription. A judge recently ruled in favor of the Center for Reproductive Rights (CRR) in a lawsuit against the FDA (see January 21, 2005 and After). Under the Bush administration, the FDA ruled that the pill, called “Plan B,” could not be sold without a prescription (see May 6, 2004 and After), a decision partially reversed in 2006. Conservative groups say the decision will make it more difficult for parents to supervise their teens; women’s rights groups say the decision strengthens the rights of women. District Judge Edward Korman ruled that the FDA’s political appointees placed politics over science in its decision to restrict over-the-counter (OTC) sales of the drug; he wrote that evidence showed White House officials pressured the FDA to reject the drug’s OTC sales. His ruling orders the FDA to allow OTC sales to 17-year olds, and to evaluate whether all age restrictions should be lifted. CRR’s Nancy Northrup says, “It’s a good indication that the agency will move expeditiously to ensure its policy on Plan B is based solely on science.” Wendy Wright of the conservative action group Concerned Women for America says, “Parents should be furious at the FDA’s complete disregard of parental rights and the safety of minors.” In 2008, a judge ruled that conservative groups had failed to prove that the drug posed a risk to anyone (see March 4, 2008). Former FDA official Susan Wood, who resigned in 2005 over the issue, says the battle over Plan B came to symbolize just how politicized the agency became under President Bush. “The FDA got caught up in a saga, it got caught up in a drama,” she says. “This issue served as a clear example of the agency being taken off track, and it highlighted the problems FDA was facing in many other areas.” [Associated Press, 4/22/2009; Washington Post, 4/23/2009] “We need to have a very strong and science-based agency, and this is one of those steps that will help strengthen it,” Wood says. [USA Today, 3/23/2009]

Ted Kennedy, shortly before his death. [Source: Mother Talkers (.com)]Senator Ted Kennedy (D-MA), who has just learned he has terminal and inoperable brain cancer, sends a letter to President Obama about his hope for health care reform. Obama will reveal some of the contents of the letter during a September address to Congress (see September 9, 2009). The letter reads in part: “I felt confident in these closing days that while I will not be there when it happens, you will be the president who at long last signs into law the health care reform that is the great unfinished business of our society. For me, this cause stretched across decades; it has been disappointed, but never finally defeated. It was the cause of my life. And in the past year, the prospect of victory sustained me—and the work of achieving it summoned my energy and determination. There will be struggles—there always have been—and they are already underway again. But as we moved forward in these months, I learned that you will not yield to calls to retreat—that you will stay with the cause until it is won. I saw your conviction that the time is now and witnessed your unwavering commitment and understanding that health care is a decisive issue for our future prosperity. But you have also reminded all of us that it concerns more than material things; that what we face is above all a moral issue; that at stake are not just the details of policy, but fundamental principles of social justice and the character of our country. And so because of your vision and resolve, I came to believe that soon, very soon, affordable health coverage will be available to all, in an America where the state of a family’s health will never again depend on the amount of a family’s wealth. And while I will not see the victory, I was able to look forward and know that we will—yes, we will—fulfill the promise of health care in America as a right and not a privilege.” Senator Kennedy compares Obama with his brother, former President John F. Kennedy, “who inspired a generation and the world,” and says he has “great hope[s] that as I leave, another young president inspires another generation and once more on America’s behalf inspires the entire world.” [White House, 5/12/2009; Salon, 9/9/2009]

On his radio show, conservative host Glenn Beck warns that the Democrats’ “socialistic” health care reform proposal will lead to “eugenics” as envisioned by leaders of the Nazi Third Reich. Beck tells his listeners that the reform package will not only result in senior citizens being forced to die before their time in order to save on medical costs (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, and February 18, 2009), but also says: “This is Nazi Germany stuff. This is the kind of stuff that is progressive in its nature. It is eugenics. It is survival of the fittest. It is the reason why the abortion argument makes so much difference. You can’t devalue life at either end because these people are waiting to swoop in and say it’s just not worth doing these things. Don’t waste the money on old people. They’re not going to live long anyway. Spend it on someone who meets the requirements of our cost-benefit analysis. So old people, thanks for all the contributions you made to society during your better years but now we’re sorry to say it’s time to send you to a better place, heaven.” [Glenn Beck, 5/13/2009]

Progressive news and advocacy Web site Think Progress profiles Tim Phillips, the president of Americans for Prosperity (AFP), the conservative Washington lobbying organization that is planning to coordinate anti-tax “tea party” protests (see April 8, 2009 and April 15, 2009) with a summer push against the White House’s health care reform proposals. AFP is largely funded by Koch Industries, the largest private oil corporation in the US; AFP has long advocated positions favorable to the energy and health care industries. AFP also uses the technique of “astroturfing,” the creation of ostensibly citizen-driven “grassroots” advocacy groups that are actually funded and driven by corporate and lobbying interests. AFP’s most recent creation is a “front group” called “Patients United Now” (PUN), a group explicitly designed to thwart health care reform. PUN’s Web site declares, “We are people just like you,” and actively solicits participation and donations from ordinary Americans without revealing its corporate roots. AFP employs close to 70 Republican operatives and former oil industry officials. Other 'Astroturf' Campaigns - Think Progress notes that other AFP “Astroturf” groups have organized events such as the “Hot Air Tour” attacking environmental regulation, the “Free Our Energy” movement to promote domestic oil drilling, the “Save My Ballot Tour” which sent conservative activist “Joe the Plumber” (see October 10, 2008) around the country attacking the Employee Free Choice Act, the “No Climate Tax” group aimed at defeating the Clean Energy Economy legislation, and the “No Stimulus” organization, which opposes the Obama administration’s economic policies. Headed by Former Abramoff Colleague - AFP’s president is Tim Phillips, a veteran conservative lobbyist and “astroturfer.” In 1997, Phillips, then a Republican campaign strategist, joined Christian conservative activists in a new lobbying firm, Century Strategies. The firm promised to mount “grassroots lobbying drives” and explained its strategy as “it matters less who has the best arguments and more who gets heard—and by whom.” Century Strategies was given a boost by Texas GOP political operative Karl Rove, and began its career representing the Texas oil giant Enron. The firm was paid $380,000 to mobilize “religious leaders and pro-family groups” to push energy deregulation on the federal and state level, an effort which helped lead, says Think Progress, “to the energy crisis and economic meltdown of 2001.” As part of their efforts, Phillips and his partner, former Christian Coalition official Ralph Reed, used their congressional connections and “placed” purported “news” articles in the New York Times and other prominent newspapers. Phillips managed the firm’s direct mail subsidiary, Millennium Marketing, which was hired by then-GOP lobbyist Jack Abramoff to pressure members of Congress to oppose federal wage and worker safety legislation. Phillips and Reed also worked with Abramoff in the lobbyists’ efforts to fraudulently charge Native American tribes millions of dollars in lobbying fees over their efforts to build casinos on tribal lands. And they helped Abramoff launder gambling money. Phillips and Reed are responsible for the ads that helped Republicans win election victories by comparing Democratic candidates to Osama bin Laden, and helped George W. Bush (R-TX) defeat Senator John McCain (R-AZ) in 2000 by accusing McCain of fathering an illegitimate black child. They were unsuccessful in preventing the 2000 election of Republican Eric Cantor (R-VA) to the House by attacking his Jewish heritage. [Think Progress, 5/29/2009]Headed by Oil Billionaire, Republican Party Funder - MSNBC’s Rachel Maddow will later note that AFP’s director is Art Pope, a multi-millionaire who has given so much money to the North Carolina Republican Party that it named its headquarters after him. The national chairman of AFP is David Koch, who with his brother runs Koch Industries, the largest privately held oil company in the US and a longtime supporter of right-wing causes. Koch is the 19th richest man in the world. [MSNBC, 8/6/2009]

US President Barack Obama issues a terse condemnation of the murder of late-term-abortion-provider Dr. George Tiller (see May 31, 2009) in a statement issued on the same day as the shooting. The president writes: “I am shocked and outraged by the murder of Dr. George Tiller as he attended church services this morning. However profound our differences as Americans over difficult issues such as abortion, they cannot be resolved by heinous acts of violence.” [White House Press Office, 5/31/2009]

Police arrest 51-year-old Scott Roeder of Merriam, Kansas, on the afternoon of May 31 in connection with the shooting of late-term-abortion-provider Dr. George Tiller in his church that morning (see May 31, 2009). Roeder is arrested about 30 miles southwest of Kansas City after eyewitnesses to the murder provide police with the license number of the killer’s getaway car. [CNN News, 5/31/2009] In 1996, Roeder, then a member of the anti-government militia group known as the Freemen, was arrested on charges of possessing explosives (see April 16, 1996). Police say they found no weapon in his possession. Roeder’s uncle Clarence Roeder issues a statement this evening: “This is a tragedy for the Tiller family and we feel so badly about that, that Scott would murder the doctor in the Lutheran church. We are also Lutherans, and that adds a double touch of sadness and irony.” Family members say they haven’t seen Scott Roeder since 2000, and he was in and out of trouble in the 1990s. [KMBC.com, 5/31/2009] In video recorded by local TV station KMBC-TV, neighbors say Roeder was not a friendly person; a landlord says he was “trouble from the start,” and was “radical” and “strange.” His ex-wife Lindsay Roeder says: “He didn’t think of the consequences this would have for anybody. There were children in that church, children that will remember that for the rest of their lives.” [KMBC-TV, 5/31/2009] In 2010, Roeder will be convicted of murdering Tiller (see January 29, 2010).

A 2002 photo of Dr. George Tiller. [Source: Abortion Essay (.com)]Dr. George Tiller, one of the handful of doctors in the USA willing to perform late-term abortions, is shot to death while attending services at the Reformation Lutheran Church in Wichita, Kansas. The 67-year-old doctor is slain in front of several witnesses by a single assailant in the foyer of his church while serving as an usher at about 10 a.m. Law enforcement officials say they believe the murder is “the act of an isolated individual,” but add that they are also looking into the suspected assailant’s “history, his family, his associates.” [CNN News, 5/31/2009; New York Times, 5/31/2009] Tiller’s murderer is eventually identified as anti-abortion activist Scott Roeder (see May 31, 2009). Murder Caps Off Years of Violence, Harassment - Tiller’s murder comes after repeated harassment and violence against him, his clinic, and his patients. In 1986, the clinic was bombed, causing serious damage. In 1991, 2,000 protesters outside the clinic were arrested over the course of the summer. In 1993, Tiller was shot in both arms outside the clinic (see August 19, 1993). During a trial for performing illegal abortions, in which he was acquitted (see March 27, 2009), Tiller testified that he had spent years under the protection of federal agents after the FBI learned in 1994 that he was a top target on an anti-abortionist assassination list. [Agence France-Presse, 5/31/2009] In recent months, Tiller had been targeted by Fox News talk show host Bill O’Reilly, who repeatedly referred to him as “Tiller the Killer.” Tiller’s clinic was defaced with a poster titled “Auschwichita,” that claimed Tiller was like Hitler because he espoused Christianity just as Hitler did. The poster also used the term “Tiller the Killer,” and called Tiller an “equal opportunity executioner.” [Sarah Jones, 10/20/2010]Responses from Family, President, Activists - Responding to Tiller’s murder, President Obama tells the nation, “However profound our differences as Americans over difficult issues such as abortion, they cannot be resolved by heinous acts of violence” (see May 31, 2009). Troy Newman, the president of the anti-abortion organization Operation Rescue (OR—see 1986), says his organization has always sought “nonviolent” measures to challenge Tiller, including efforts in recent years to have him prosecuted for crimes or investigated by state health authorities. “Operation Rescue has worked tirelessly on peaceful, nonviolent measures to bring him to justice through the legal system, the legislative system,” Newman says. “We are pro-life, and this act was antithetical to what we believe.” Newman says that Roeder may have posted on OR-hosted Web sites, but says of the suspect, “He is not a friend, not a contributor, not a volunteer.” The media will quickly unearth deeper ties between OR and Roeder than Newman initially acknowledges (see May 31, 2009). In a statement, the Tiller family says: “George dedicated his life to providing women with high-quality health care despite frequent threats and violence. We ask that he be remembered as a good husband, father, and grandfather, and a dedicated servant on behalf of the rights of women everywhere.” [New York Times, 5/31/2009]

TV station KMBC reports on the arrest of Scott Roeder in connection with the murder of late-abortion-providing OB/GYN Dr. George Tiller (see May 31, 2009), and mentions an envelope found in the getaway car with the words “Op Rescue” and “Cheryl” and a phone number on it. [KMBC-TV, 6/3/2009] Kansas news blogger Justin Kendall finds out that the number is a direct line to Cheryl Sullenger, a senior policy advisor with Operation Rescue, a hardline anti-abortion activism group. Sullenger served two years imprisonment after bombing an abortion clinic in 1988. She tells Kendall she hasn’t spoken to Roeder recently and says: “You know, he’s somebody who’s been around. My name is on the Internet. It’s on every press release. My phone number is on every press release it. It’s all over the Internet. I don’t know. He probably has lots of people’s phone numbers.” [The Pitch, 6/1/2009] Sullenger says she kept Roeder up to date on court hearings involving Tiller, who was acquitted of failing to properly justify late-term abortions in January 2009: “He would call and say, ‘When does court start? When’s the next hearing?’ I was polite enough to give him the information. I had no reason not to. Who knew? Who knew, you know what I mean?” [Kansas City Star, 6/3/2009] Kendall also reveals that in a May 2007 comment on an Operation Rescue forum, a “Scott Roeder” advocated attending Tiller’s church—the eventual scene of his murder—with “as many people as possible” to ask questions of church leaders and members and bring attention to Tiller. [Scott Roeder, 5/19/2007] In 1996, Roeder, then a member of the anti-government militia group known as the Freemen, was arrested on charges of possessing explosives (see April 16, 1996). In 2010, Roeder will be convicted of murdering Tiller (see January 29, 2010).

Fellow anti-abortionists say that Scott Roeder, arrested in connection with the murder of late-term-abortion-providing OB/GYN Dr. George Tiller (see May 31, 2009), has long been a hard-line opponent of abortion. Kansas anti-abortion activist Regina Dinwittie, who was ordered by a judge to cease using a bullhorn within 500 feet of an abortion clinic in 1995, says: “I know that he believed in justifiable homicide. He very strongly believed that abortion was murder and that you ought to defend the little ones, both born and unborn.” Dinwittie recounts Roeder confronting Dr. Robert Crist, who worked at the Kansas City Planned Parenthood clinic in 1996: “He stared at him for approximately 45 seconds. Then he [Roeder] said, ‘I’ve seen you now.’ Then he turned his back and walked away, and they were scared to death.” [Kansas City Star, 5/31/2009] Dinwittie says she herself is “glad” of Tiller’s death, saying, “I wouldn’t cry for him no more than I would if somebody dropped a rat and killed it.” [Associated Press, 6/1/2009] After attending Tiller’s trial, Roeder told fellow Kansas anti-abortion activist Eugene Frye that the whole process was “a sham.” Frye says, “He felt justice had not been served.” [Kansas City Star, 6/2/2009] “In this situation, Scott viewed Tiller as the violent person,” Frye said. “Scott didn’t see himself as that. He saw this man as perpetrating murder on these innocent babies.… Scott had that conviction.” [Kansas City Star, 6/5/2009] Dave Leach, publisher of the Iowa magazine Prayer and Action News, which has said “justifiable homicide” against abortion providers can be supported, and to which Roeder subscribed, says: “Scott is not my hero in that sense; he has not inspired me to shoot an abortionist. But definitely, he will be the hero to thousands of babies who will not be slain because Scott sacrificed everything for them.” [Associated Press, 6/1/2009] In signing a petition against Tiller in September 2007, someone giving the name Scott Roeder wrote, “Tiller is the concentration camp ‘Mengele’ of our day and needs to be stopped before he and those who protect him bring judgment upon our nation.” [Scott Roeder, 9/3/2009] In 1996, Roeder, then a member of the anti-government militia group known as the Freemen, was arrested on charges of possessing explosives (see April 16, 1996).

Former anti-abortion activist Frank Schaeffer, author of the book Crazy for God: How I Grew Up as One of the Elect, Helped Found the Religious Right, and Lived to Take All (or Almost All) of It Back, says publicly that the religious right anti-abortion movement shares the blame for the murder of late-term-abortion-provider George Tiller (see May 31, 2009). In a column on the “Huffington Post” website, Schaeffer writes that, in books they wrote that were bestsellers on the religious right, both he and his father, Francis Schaeffer, advocated using force to stop abortion if legal avenues failed. His father, he writes, “compared America and its legalized abortion to Hitler’s Germany and said that whatever tactics would have been morally justified in removing Hitler would be justified in trying to stop abortion.” He points out that Paul Hill, who was executed in 2003 for murdering abortion provider Dr. John Bayard Britton and one of his volunteer escorts in 1994, was “an avid follower of my father’s.” Schaeffer, who left the religious right in the mid 1980s, writes that he is “very sorry” for his own part. [Huffington Post, 6/1/2009] In an interview on the “Rachel Maddow Show,” Schaeffer apologizes again for the anti-abortion campaign he helped found and build, and says, “[T]his is what helps unhinge a society.” [MSNBC, 6/1/2009]

Scott Roeder [Source: Kansas City Star]After his arrest in connection with the murder of late-term abortion provider Dr. George Tiller in Wichita, Kansas (see May 31, 2009), Scott Roeder is charged with one count of first-degree murder and two counts of aggravated assault. The latter charges are for pointing a gun at two men who were eyewitnesses to the murder. Roeder requests that the court appoint counsel for him and is referred to the public defender’s office. [Wichita Eagle, 6/2/2009] District Attorney Nola Foulston explains that the state will not seek the death penalty, as Kansas law sets out seven required criteria for a capital charge, none of which fit the Tiller murder. The maximum sentence for first-degree murder in Kansas is life imprisonment. [Wichita Eagle, 6/4/2009] In 1996, Roeder, then a member of the anti-government militia group known as the Freemen, was arrested on charges of possessing explosives (see April 16, 1996). In 2010, Roeder will be convicted of murdering Tiller (see January 29, 2010).

Jeffery Pederson, office manager of the Central Family Medicine/Aid for Women Clinic in Kansas City, says that he reported to both the FBI and local police that a man whose description and license plate matched those of Scott Roeder, the man charged with murdering late-abortion-provider Dr. George Tiller (see May 31, 2009), had glued the locks of the clinic doors. One of the reports was made the day before the killing. “I was just sick,” Pederson says. “That was the plate I gave the FBI Saturday [May 30]. I called the FBI back and said, ‘It’s the same car. It’s the same guy.’” FBI spokeswoman Bridget Patton says, “When we are notified when vandalism occurs at a clinic, we look into the matter, but we’re not going to comment on anything regarding that incident.” Kansas City police spokesman Michael Golden says the police report resulting from Pederson’s complaint contained “no suspect information.” [Kansas City Star, 6/2/2009] In an interview with Amy Goodman of Democracy Now!, Pederson says that he told the FBI the vandal’s first name, Scott, which his staff knew from anti-abortion protests at the clinic, as well as giving them his license plate number and security camera videos. He also notes that complaints to the FBI of the same man committing similar vandalism in 2000 resulted in no action other than “talking to” Roeder. [Democracy Now!, 6/4/2009] A New York Times editorial will later criticize the FBI for not being more vigilant. [New York Times, 6/7/2009]

Max Baucus (D-MT), the chairman of the Senate Finance Committee, meets with advocates of “single-payer,” or government-run health insurance. Baucus recently chaired hearings on health care reform which excluded single-payer advocates (see April 21-May 12, 2009). He meets with representatives of the advocacy group Physicians for a National Health Program (PHNP), two Harvard University medical professors, a medical school dean, and representatives of the California Nurses Association. One of the participants, Dr. David Himmelstein of PHNP, says: “Bowing to mounting pressure from single-payer advocates around the nation, Senator Baucus has asked to meet with some representatives of the single-payer movement.… We have no illusions that our discussions alone will persuade Senator Baucus to back a single-payer bill. But the meeting is a clear indication that demonstrations and activism can move even our money-corrupted political culture.” Some polls show that a majority of Americans back single-payer insurance, as do doctors and health economists. [Single Payer Action, 5/31/2009]

In a phone interview from jail with the Associated Press, Scott Roeder, who is charged with first degree murder in the shooting death of late-term abortion provider George Tiller (see May 31, 2009), complains, “I haven’t been convicted of anything, and I am being treated as a criminal.” Roeder objects to the media attention received by his family, and says, “I appreciate your prayers.” [Life Site News, 6/5/2009] He also complains about “deplorable conditions in solitary,” saying he is worried about contracting pneumonia because his cell is cold and he needs a CPAP machine for his sleep apnea. [New York Daily News, 6/7/2009]

Phoning the Associated Press from his jail cell, Scott Roeder, the suspect in the murder of late-term abortion provider George Tiller (see May 31, 2009), says, “I know there are many other similar events planned around the country as long as abortion remains legal.” He refuses to elaborate. A Justice Department spokesperson says the threat is being taken seriously, but Troy Newman, president of the anti-abortion organization Operation Rescue, dismisses it, saying, “This guy is a lunatic.” [Associated Press, 6/7/2009] In response, Judge Warren Wilbert raises Roeder’s bond amount from $5 million to $20 million, citing concerns that Roeder could “perpetuate, participate or enact any more violence on his own or in concert with others.” The judge explains that his decision is influenced in part by police having discovered weapons and explosives in his possession in 1996, which he said he planned to use on an abortion clinic (see April 16, 1996). [Associated Press, 6/14/2009]

Flowers adorn the sidewalk outside George Tiller’s clinic in Wichita, Kansas, laid in his memory. [Source: AP: Charlie Riedel]The family of George Tiller, a doctor who provided late-term abortions as part of his practice before being murdered (see May 31, 2009), decides that his Wichita, Kansas, clinic will be closed permanently. Nebraska doctor LeRoy Carhart, who worked at the clinic, said he was willing to continue, but the decision is the family’s. Warren Hern, one of the few remaining doctors in the US who performs late-term abortions, says: “This is what they want, they’ve been wanting this for 35 years. The anti-abortion fanatics have to shut up and go home. They have to back off and they have to respect other people’s point of view. This is a national outrage.” Randall Terry, original founder of the anti-abortion group Operation Rescue, says, “Good riddance,” and predicts that Tiller’s clinic will be remembered similarly to Nazi death camps. In a statement, the Tiller family says, “We are proud of the service and courage shown by our husband and father and know that women’s health care needs have been met because of his dedication and service.” [Associated Press, 6/9/2009]

The US spends more than any other nation in the world on health care, but ranks only 50th among 224 nations in life expectancy, according to the 2009 CIA World Factbook. Experts say that this fact could raise serious questions in the debate over health care reform. Americans have an average life span of 78.1 years; the populations of 49 other nations live longer, on average. Japan is first in life expectancy, at 83 years; Australia, Iceland, Italy, San Marino, Switzerland, Andorra, Canada, and France round out the top 10 countries. Other countries, such as Sweden, Norway, Denmark, Singapore, Greece, Spain, and Portugal also do better than the US in life expectancy. The bottom 10 nations are, in reverse order, Sierra Leone, Afghanistan, Zimbabwe, Lesotho, Zambia, Chad, Uganda, Swaziland, Mozambique, and Guinea-Bissau, with life spans ranging from averages of 41 to 48 years. Some experts note that the US is the only developed nation to have a virtually completely privatized health care system. “What we are able to find in the industrialized world is that life expectancy will be influenced in a beneficial manner to the extent that health care expenditure is publicly financed,” says public health professor Harvey Brenner. “The higher the government expenditure on health care, the lower will be the mortality rate.” A study from the University of Chicago shows that a single-payer system—government-run health care—may be associated with higher life expectancy. The governments of such nations as Norway, Sweden, Denmark, Australia, and Canada have government-run health care, and their citizens have some of the longest life spans in the world. The author of the study, Bianca Frogner, writes: “Inevitably the conversation about reforming our health care system focuses on the question of what are we getting for our money and how are others doing with their health care dollars. Life expectancy, along with mortality and morbidity rates, are fairly straightforward numbers to rely on.” Other comparisons show that Scandinavian and other European countries have lower birth mortality numbers than the US, though babies born with abnormally low birth weights tend to fare better in the US system than in the Scandinavian systems. [CNN, 6/11/2009]

Dan Monnat, who acted as George Tiller’s attorney until the late-term abortion provider was murdered (see May 31, 2009), discusses his relationship with Tiller, and the fears and threats leading up to the murder, in a lengthy interview with the Wichita Eagle. One observation he makes is that, since Barack Obama came into office, federal authorities have been more attentive to complaints of vandalism against abortion clinics. “I think there had been other requests during the previous administration for Dr. Tiller’s clinic to be protected under the FACE [Freedom of Access to Clinic Entrances] Act and nobody had done anything,” he says. However, when clinic staff reported vandalism on May 1 that showed “a little more cloak and dagger planning and sophistication” than most acts of vandalism, according to Monnat, the FBI opened an investigation (see June 2, 2009). Federal authorities say they will investigate a possible conspiracy in the Tiller murder. [Wichita Eagle, 6/13/2009]

After announcing plans to commemorate the death and clinic closing of murdered late-term-abortion-providing OB/GYN George Tiller (see May 31, 2009) by laying flowers at the clinic building, hardline anti-abortion group Operation Rescue changes the location of the event to its Wichita headquarters due to an announced counter-protest by abortion rights supporters. However, about ten abortion opponents return to the clinic in the evening to lay hundreds of flowers, after the abortion rights supporters have left. [Operation Rescue, 6/20/2009] Marla Patrick, state co-ordinator for the National Organization for Women, which organized the counter-protest, says: “Our original intent was to prevent them from doing their proverbial dance on a murdered man’s grave. The fact they changed plans tells me we were successful.” [Associated Press, 6/20/2009] Suspicions persist of murder suspect Scott Roeder’s connection with Operation Rescue (see May 31, 2009).

Representative Tim Bishop (D-NY) holds a “town hall” meeting in Setauket, New York, to attempt to discuss the White House’s health care reform package. However, the town hall is disrupted by a large number of angrily shouting conservatives, there to protest the reform proposals. The protesters hound Bishop throughout the meeting, shouting him down when he attempts to speak, and accusing him of “selling out” the country through his positions on the White House’s energy, economic, and health care policies. The mob becomes so threatening that five police officers are forced to escort Bishop to his car for his own safety. In part because of the incident, Bishop will suspend further town hall meetings until August 2009. Bishop has held over 100 such meetings since his election to Congress in 2002. [Politico, 7/31/2009; MSNBC, 8/4/2009]

President Obama, in a televised “town hall” event held in the White House to discuss health care reform, suggests that one way to trim medical costs might be to cease performing expensive and futile treatments—“extraordinary measures”—on terminally ill patients who do not want such interventions and would not benefit from them. Currently, doctors who have no particular instructions will perform “extraordinary measures” to stave off a terminally ill patient’s death, even for a matter of hours, no matter how intrusive or expensive the procedure. Obama tells his listeners that families need better information so they don’t unthinkingly approve “additional tests or additional drugs that the evidence shows is not necessarily going to improve care.” In some instances, he says, “Maybe you’re better off not having the surgery, but taking the painkiller.” He notes the experience of his recently deceased grandmother, Madelyn Dunham, was diagnosed with terminal cancer and given less than nine months to live. When she broke her hip, she and her family had to decide whether to put her through a long, expensive, and painful hip-replacement procedure. “[A]nd the question was, does she get hip replacement surgery, even though she was fragile enough they were not sure how long she would last?” he says. [Los Angeles Times, 6/25/2009] Obama is not advocating that life-extending treatments be forcibly denied to terminally ill or elderly patients (see July 23, 2009 and July 23, 2009), but his remarks will be misconstrued as advocating just such a position (see June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23-24, 2009, and July 24, 2009, July 28, 2009, July 28, 2009, July 28, 2009, July 31, 2009 - August 12, 2009, August 7, 2009, August 10, 2009, Shortly Before August 10, 2009, August 11, 2009, and August 12, 2009).

Capital Research Center senior editor Matthew Vadum writes an op-ed for the conservative American Spectator magazine claiming that President Obama is sending a message to America’s elderly in his health care reform proposals: “Screw you.” Referring to a statement made by Obama at a “town hall” forum on health care reform, where the president noted that money could be saved by trimming unwanted and unneeded “extraordinary measures” carried out on terminally ill patients (see June 24, 2009), Vadum writes: “So, old people: screw you. In the future Uncle Sam will put you on an ice floe and let you float away to your heavenly reward. It gives new meaning to the Latin phrase ‘Dulce et decorum est pro patria mori.’ (In English, How sweet and glorious it is to die for one’s country.) Medical decisions should be made by patients, their families, and their doctors, not by government bureaucrats, but that’s ObamaCare for you.” [American Spectator, 6/25/2009]

Fake ‘ObamaCare’ card distributed by FreedomWorks. [Source: FreedomWorks]The corporate lobbying firm FreedomWorks (see April 14, 2009) sends out a detailed memo, written in part by founder Dick Armey (R-TX), laying out strategies for protesting the Obama administration’s health care reform proposals. The memo claims that the White House intends to supplant the current privately owned and operated health care system with a “government-run” system “that would cost taxpayers trillions of dollars in new taxes” and feature “government bureaucrats,” not doctors and patients, deciding who received what health care. “This takeover of the health care system would be costly in terms of our money, our freedom, and even our lives,” the memo states. Members and sympathizers should descend on the “town hall” meetings and other venues hosted by their Congressional representatives and demand that they oppose the proposals. The memo states that its “action kit” should be used at the “tea parties” being sponsored by FreedomWorks and other right-wing organizations (see April 14, 2009, April 15, 2009, and May 29, 2009). The memo contains talking points, slogans, sample questions, a “sample” letter to the editor that members can copy and sign, a petition, and a satirical “Obamacare Card” issued to “Nancy P. Pelosi,” the Democratic Speaker of the House, saying that the bearer is entitled to “rationed health care, long waits, less choice and control, poorer care, fewer doctors and drugs, massive government, higher taxes, growing debt, zero innovation, rising costs, waste, fraud, and abuse, [and] anxiety, pain, [and] fear of death.” [Dick Armey, 6/26/2009 ]

Moderate Republican House member Mike Castle (R-DE) faces a raucous band of angry conservative protesters at one of his “health care listening tour” meetings. Castle, who is one of eight Republicans to join the Democratic majority in voting for the American Clean Energy and Security Act, is challenged by a full range of accusations and conspiracy theories, some ranging far afield from health care reform and energy policy. 'Socialized Medicine' Worse than 9/11 - Some audience members accuse Castle of supporting “socialized medicine.” One member shouts, “I don’t have the answers for how to fix the broken pieces of our health care system, but I know darn well if we let the government bring in socialized medicine, it will destroy this thing faster than the twin towers came down.” 'Cap and Trade' Tax Will Destroy Economy - One audience member shouts that the proposed “cap and trade” tax on pollutants will destroy the US economy. “Do you have any idea what that cap and trade tax thing, bill that you passed is going to do to the Suffolk County poultry industry?” the member says. “That’s how chicken houses are heated, with propane. It outputs CO2. I mean, I’m outputting CO2 right now as I speak. Trees need CO2 to make oxygen! You can’t tax that!” Global Warming a 'Hoax' - Many audience members respond with cheers and chants to expressions that global warming is a hoax. “I’m actually hopeful that this vote that you made was a vote to put you out of office,” one says to a barrage of applause and cheers. “You know, on this energy thing, I showed you, I had in my email to you numerous times there are petitions signed by 31,000 scientists that that know and have facts that CO2 emissions have nothing to do and the greenhouse effect has nothing to do with global warming. It’s all a hoax! [Applause.] First of all, I cannot for the life of me understand how you could have been one of the eight Republican traitors!” Another audience member says that global warming is “still a theory, so is Darwin’s theory of evolution! And yet we have the audacity to say global warming is accurate, it’s more than a theory? How about how cold it’s been this spring. Personal data, data shows that since 1998 average temperatures have been cooling!” 'Dead Baby Juice' Used to Create AIDS, Swine Flu - Some audience members believe that AIDS and the H1N1 “swine flu” epidemic are part of a conspiracy to kill Americans, using “dead baby juice.” “The virus was built and created in Fort Dix, a small bioweapons plant outside of Fort Dix,” one audience member asserts. “This was engineered. This thing didn’t just crop up in a cave or a swine farm. This thing was engineered, the virus. Pasteur International, one of the big vaccine companies in Chicago, has been caught sending AIDS-infected vaccines to Africa. Do you think I trust—I don’t trust you with anything. You think I’m going to trust you to put a needle full of dead baby juice and monkey kidneys? Cause that’s what this stuff is grown on, dead babies!” Obama a Kenyan - One audience members wins a round of applause by asserting that President Obama is not an American citizen. “Congressman Castle, I want to know,” she shouts. “I have a birth certificate here from the United States of America saying I’m an American citizen, with a seal on it. Signed by a doctor, with a hospital administrator’s name, my parents, the date of birth, the time, the date. I want to go back to January 20th and I want to know why are you people ignoring his birth certificate? He is not an American citizen! He is a citizen of Kenya!” Protests Organized by Conservative Lobbying Organizations - According to liberal news and advocacy site Think Progress, Castle and other moderate Republicans are facing orchestrated attacks on their energy and health care policies by conservative lobbying firms and right-wing talk show hosts. Lobbying organizations such as Americans for Prosperity (AFP—see May 29, 2009) have tarred Castle and other moderate Republicans as “cap and traitors,” joined by members of Fox News host Glenn Beck’s “9-12” organization (see March 13, 2009 and After) and exhorted by pronouncements from Beck, fellow talk show host Rush Limbaugh, the Web site Prison Planet, and others. [Think Progress, 7/21/2009]

A Syracuse “town hall” meeting hosted by Democratic House member Dan Maffei (D-NY) turns ugly after police are forced to intervene to restore order. During the meeting, held at Lincoln Middle School and focusing on health care reform, conservative anti-reform protesters cause disruption with shouts, curses, and screams that repeatedly drown out both Maffei’s remarks and the questions and comments from the audience, which numbers around 400. Many of the protesters are members of one or another “tea party” groups (see April 8, 2009), which have long opposed the policies of the Obama administration. The worst of the attempts to shout down discussion comes when Maffei or audience members bring up the idea of the “public option,” the idea of a government-run alternative health care plan similar to Medicare or Medicaid. Some pro-reform audience members bicker with the anti-reformists, adding to the cacophany. Maffei will later say he believes many of the loudest and most discourteous anti-reform protesters were not from the district, but had been brought in by special interest groups (see July 23, 2009 and August 4, 2009). “Many of them are not even from the Congressional district,” Maffei says. “But we’re not going to check driver’s licenses and ask people if they live in the district. It’s very, very unfortunate.” After the meeting, Maffei says he is considering other formats for such meetings; he says any such format should allow everyone to speak and discuss ideas in a respectful fashion. “This has been a problem going on a little bit with our public meetings,” he says. “It just makes me think we can do a better job with the format.” [Syracuse Post-Standard, 7/12/2009; TPMDC, 8/3/2009]

Wendell Potter (r) being interviewed by Bill Moyers (l). [Source: PR Watch (.org)]Former health care executive Wendell Potter, who left the insurance giant Cigna after fifteen years, appears on “Bill Moyers’ Journal.” He was formerly the head of corporate communications before he resigned his position, a post he calls “the ultimate PR job.” He says he was not forced to leave the company, and was extremely well compensated for his duties. He left after realizing that the health care industry is using underhanded and hurtful tactics to undermine the drive towards health care reform. He never went to his bosses with his observations because, he says, “for most of the time I was there, I felt that what we were doing was the right thing. And that I was playing on a team that was honorable. I just didn’t really get it all that much until toward the end of my tenure at Cigna.” Health Care Expo Changed His Perceptions - In June 2007, Potter recalls, his perceptions were drastically changed by his visit to a health care exposition in Wise, Virginia (see June 2007). Changing Plans - The industry shifted from selling primarily managed care plans, he says, to what they call “consumer-driven plans.” Despite the name, they are health care plans with high deductibles and limited coverage. 'Highlight Horror Stories' - Moyers shows Potter a copy of an “action plan” devised by America’s Health Insurance Plans (AHIP), the industry’s trade association. In large gold letters, the plan tells lobbyists and industry representatives to “Highlight horror stories of government-run systems.” Potter says that AHIP and other industry representatives try to paint government-run health care as socialism, and as inevitable failures. “The industry has always tried to make Americans think that government-run systems are the worst thing that could possibly happen to them,” he says, “that if you even consider that, you’re heading down on the slippery slope towards socialism. So they have used scare tactics for years and years and years, to keep that from happening. If there were a broader program like our Medicare program, it could potentially reduce the profits of these big companies. So that is their biggest concern.” Moyers also notes that the AHIP plan targets the film Sicko, a 2007 documentary by leftist filmmaker Michael Moore that portrayed America’s health care industry in a dismal light. AHIP’s action plan is to “Position Sicko as a threat to Democrats’ larger agenda.” Potter says that was an effort to discredit the film by using lobbyists and AHIP staffers “to go onto Capitol Hill and say, ‘Look, you don’t want to believe this movie. You don’t want to talk about it. You don’t want to endorse it. And if you do, we can make things tough for you.’” If they did, AHIP would retaliate by running negative ads against the lawmakers in their home districts or other electoral punishments. AHIP focused strongly on the conservative Democratic Leadership Council. Another tactic, as delineated in the memo: “Message to Democratic insiders. Embracing Moore is one-way ticket back to minority party status.” Moyers says that AHIP attempted to “radicalize” Moore and portray him as an extremist who could not be believed. Many politicians used AHIP talking points in discussing Moore and his film. “So your plan worked,” Moyers observes. Potter agrees: “It worked beautifully.” The lesson that was lost from Moore’s film, Potter says, was that Americans “shouldn’t fear government involvement in our health care system. That there is an appropriate role for government, and it’s been proven in the countries that were in that movie.” Conservative Counter-Strategy - Moyers then displays a memo from Republican strategist Frank Luntz, who in the spring of 2009 wrote a strategy memo for health care reform opponents. The memo reads in part: “First, you have to pretend to support it. Then use phrases like, ‘government takeover,’ ‘delayed care is denied care,’ ‘consequences of rationing,’ ‘bureaucrats, not doctors prescribing medicine.’” He then shows film clips of House Minority Leader John Boehner (R-OH), Senate Minority Leader Mitch McConnell (R-KY), Senator Jon Kyl (R-AZ), and others using Luntz’s talking points in discussions on the floors of Congress. Potter says that many conservatives—Democrats as well as Republicans—“are ideologically aligned with the industry. They want to believe that the free market system can and should work in this country, like it does in other industries. So they don’t understand from an insider’s perspective like I have, what that actually means, and the consequences of that to Americans. They parrot those comments, without really realizing what the real situation is.” He notes that Representative Zach Wamp (R-TN), who grew up very near Potter’s childhood home in Chattanooga, told reporters that half of America’s uninsured don’t want health care, they would rather “go naked and just take the chance of getting sick. They end up in the emergency room costing you and me a whole lot more money.” Potter notes that the word “naked” is an industry term for people who choose not to buy health insurance. He calls Wamp’s comment “ridiculous” and “an example of a member of Congress buying what the insurance industry is peddling.” Moyers cites conservative Democrat Max Baucus, the chairman of the Senate Finance Committee, as another politician central to the health care reform process who is heavily influenced by corporate lobbyists—two of whom used to work on his own Senate staff. Potter says: “[I]t does offend me, that the vested special interests, who are so profitable and so powerful, are able to influence public policy in the way that they have, and the way that they’ve done over the years. And the insurance industry has been one of the most successful, in beating back any kinds of legislation that would hinder or affect the profitability of the companies.” Fierce Opposition to Public Option - The “public option,” the idea that the government would extend a non-profit, government-run health care alternative for citizens, is fiercely opposed by the health care industry. Potter says the reason why is “[t]he industry doesn’t want to have any competitor. In fact, over the course of the last few years, has been shrinking the number of competitors through a lot of acquisitions and mergers. So first of all, they don’t want any more competition period. They certainly don’t want it from a government plan that might be operating more efficiently than they are, that they operate.” Government programs such as Medicare and the Veterans Administration’s medical providers are far more efficient than private, for-profit health care providers, and the industry fears that having to compete with such a program will slash their profits. Medical companies will do whatever it takes to keep their profit margins—and shareholder returns—above a certain threshold. They will deny more claims, kick more people off their rolls, purge employer accounts, whatever it takes. Potter, evidently bemused, says, “You know, I’ve been around a long time. And I have to say, I just don’t get this. I just don’t understand how the corporations can oppose a plan that gives the unhealthy people a chance to be covered. And they don’t want to do it themselves.… I’m a capitalist as well. I think it’s a wonderful thing that companies can make a profit. But when you do it in such a way that you are creating a situation in which these companies are adding to the number of people who are uninsured and creating a problem of the underinsured then that’s when we have a problem with it, or at least I do.” A public option would help “keep [health care corporations] honest,” he says, and they would inevitably lose profits. Predictions - Right now the industry is primarily involved in what Potter calls a “charm offensive,” where it is attempting to give the perception that it, too, is for health care reform. But once Congress begins putting out specific legislative language, the industry and its flacks will begin attacking specific provisions. Moyers says the upshot is for the industry to either “kill reform” or prevent lawmakers from agreeing on a bill, just like what happened in 1993-94 under the Clinton administration. No matter what they say—favoring the elimination of pre-existing condition restrictions, for example—the industry will adamantly oppose reform of any kind. “They don’t want a public plan,” Potter says. “They want all the uninsured to have to be enrolled in a private insurance plan. They want—they see those 50 million people as potentially 50 million new customers. So they’re in favor of that. They see this as a way to essentially lock them into the system, and ensure their profitability in the future. The strategy is as it was in 1993 and ‘94, to conduct this charm offensive on the surface. But behind the scenes, to use front groups and third-party advocates and ideological allies. And those on Capitol Hill who are aligned with them, philosophically, to do the dirty work. To demean and scare people about a government-run plan, try to make people not even remember that Medicare, their Medicare program, is a government-run plan that has operated a lot more efficiently.… [T]hey want to scare you into thinking that through the anecdotes they tell you, that any government-run system, particularly those in Canada, and UK, and France that the people are very unhappy. And that these people will have to wait in long lines to get care, or wait a long time to get care. I’d like to take them down to Wise County. I’d like the president to come down to Wise County, and see some real lines of Americans, standing in line to get their care. [PBS, 7/10/2009]

House Representative Paul Broun (R-GA—see November 11, 2008) says that the Obama health care reform proposals will kill Americans. On the floor of the House, Broun attacks the idea of a “public option,” described by Congressional Democrats as a government-funded alternative to private health care. Broun says, “[T]his program of ‘government option’ is being touted as being the panacea, the savior of allowing people to have quality health care at an affordable price is gonna kill people.” Broun says that Canada and the United Kingdom, both countries that rely on public health care, “don’t have the appreciation of life as we do in our society.” Progressive news and advocacy site Think Progress notes that both Canada and the UK have both a lower infant mortality rate and longer life expectancy than the US. [Think Progress, 7/10/2009] Liberal media watchdog site Media Matters notes that neither the Canadian nor British health care systems serve as models for President Obama’s health care reform proposals. [Media Matters, 7/10/2009] Broun’s claims are based in part on health insurance advocate Betsy McCaughey’s warnings that the health care reform proposal will encourage senior citizens to die sooner (see February 9, 2009 and July 23-24, 2009), warnings that are debunked by the St. Petersburg Times (see July 23, 2009).

Senator Tom Coburn (R-OK), speaking on the Washington Times’s America’s Morning News television broadcast, says the Democrats’ proposed government-run health care system—the so-called “public option”—will “absolutely” kill more people than it will save. Will “government-run health care… end up killing more people than it saves?” the interviewer asks Coburn. He responds, “Absolutely.” Coburn’s comments are echoed on the floor of the House by two Republicans. Steve King (R-IA) tells members that the government is “going to save money by rationing care, getting you in a long line. Places like Canada, United Kingdom, and Europe. People die when they’re in line.” And Louis Gohmert (R-TX) states: “One in five people have to die because they went to socialized medicine!… I would hate to think that among five women, one of ‘em is gonna die because we go to socialized care.” [Real Clear Politics, 7/16/2009; Think Progress, 7/16/2009]

Betsy McCaughey, the chairman of the Committee to Reduce Infection Deaths, a former Republican lieutenant governor of New York, and a conservative opponent of health care reform, says that under the Obama administration’s reform proposal, elderly Americans would be encouraged to die earlier to save money (see February 9, 2009 and July 23-24, 2009). On conservative radio host Fred Thompson’s show, she says, “Congress would make it mandatory—absolutely require—that every five years people in Medicare have a required counseling session that will tell them how to end their life sooner.” These sessions will help elderly patients learn how to “decline nutrition, how to decline being hydrated, how to go in to hospice care… all to do what’s in society’s best interest or in your family’s best interest and cut your life short.” [St. Petersburg Times, 7/23/2009] “These are such sacred issues of life and death. Government should have nothing to do with it.” Thompson calls McCaughey’s claim the “dirty little secret” of the health care reform proposal. [St. Petersburg Times, 7/23/2009; Politico, 7/28/2009] In August, progressive MSNBC host Rachel Maddow will tell her listeners: “That is not true at all, not a word of it. Not mandatory, not require, not every five years, not counseling, not tell them, not how to, not end their life. None of the words in that claim are true except maybe the two ‘that’s’ and the word ‘in.’ It’s not true, but it is convenient, and so it survives. And it is in fact being promoted more than ever. It’s convenient for the interests [that oppose] health care reform to scare old people about reform.” [MSNBC, 8/12/2009] The next day, McCaughey publishes an op-ed in the New York Post advancing the same arguments. “One troubling provision” of the bill, she writes, “compels seniors to submit to a counseling session every five years… about alternatives for end-of-life care.… [The] mandate invites abuse, and seniors could easily be pushed to refuse care.” [New York Post, 7/17/2009]Availability of Discussions Mandated Since 1990 - The provision in question states that as part of an advanced care consultation, an individual and practitioner will have a consultation that includes “an explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.” Such explanations and consultations have been part of government-provided senior care since 1990; in 2003, the Bush administration issued guidelines for physicians’ discussion of end-of-life care with seniors. Claims Contradicted - John Rother of the American Association of Retired Persons (AARP) counters with a statement: “This measure would not only help people make the best decisions for themselves but also better ensure that their wishes are followed. To suggest otherwise is a gross, and even cruel, distortion—especially for any family that has been forced to make the difficult decisions on care for loved ones approaching the end of their lives.” Jon Keyserling of the National Hospice and Palliative Care Organization adds: “I was surprised that any responsible legislative analyst would indicate this is a mandatory provision. That is just a misreading of the language and, certainly, of the intent.” McCaughey later responds to those statements by repeating her assertions, saying that doctors would “pressure” seniors to accept less costly services that would lead to quicker deaths. [St. Petersburg Times, 7/23/2009; Politico, 7/28/2009]Debunked - McCaughey’s claims will soon be disproven (see July 23, 2009).

Laura Ingraham. [Source: Pat Dollard]Fox News and radio talk show host Sean Hannity tells his radio audience of the op-ed published in the morning’s New York Post by health industry lobbyist Betsy McCaughey, claiming that the Democrats’ health care reform proposal would result in senior citizens being advised to end their lives prematurely (see July 16, 2009). Hannity says: “[I]t sounds to me like they’re actually encouraging seniors in the end, ‘Well, you may just want to consider packing it all in here, this is—’ what other way is there to describe this?… So that they don’t become a financial burden on the Obamacare system? I mean that’s how they intend to cut cost, by cutting down on the health care we can give and get at the end of our lives and dramatically cutting it down for senior citizens? You know, welcome to the brave new world of Obamacare. We’re going to encourage, you know, inconvenient people to consider ‘alternatives to living.’” The same day, conservative radio host Laura Ingraham tells her listeners: “Can you imagine—if I were doing Saturday Night Live, like, if I were producing it this weekend, and I was going to be fair about political humor, I would have a hospice chute—like a door, a trap door that goes into a chute where the elderly would just walk up—‘Oh, my hip hurts.’ And all of a sudden you see this leg kicking granny down the chute, and that’s Obamacare.” She continues by making a veiled reference to Nazi concentration camps: “[S]ome will call them death camps, but this is the way Obamacare is gonna go for America.” And on the same day, conservative radio hosts Jim Quinn and Rose Tennent echo Hannity and Ingraham’s claims. Quinn says, “[T]here’s a drop dead date, you should pardon the expression but a lot of us are going to—” Tennent interjects, “Are going to drop dead, yeah.” Quinn then adds, “For heaven’s sakes, this is the death-to-old-people plan.” [Media Matters, 7/17/2009]

Republicans intend to use the fight over health care reform to “break” President Obama, says at least one Republican senator. Jim DeMint (R-SC) joins other Republican lawmakers in a conference call with so-called “tea party” organizers (see April 14, 2009, April 15, 2009, May 29, 2009, August 4, 2009, August 5, 2009, and Before August 6, 2009) to plan how to use town hall confrontations with Democratic lawmakers to help stall any health care reform bill from being voted on in Congress until at least after the August recess. The call was organized by the lobbying organization Conservatives for Patients Rights (CPR). “I can almost guarantee you this thing won’t pass before August, and if we can hold it back until we go home for a month’s break in August,” members of Congress will hear from “outraged” constituents, DeMint says. “Senators and Congressmen will come back in September afraid to vote against the American people.… [T]his health care issue is D-Day for freedom in America. If we’re able to stop Obama on this it will be his Waterloo. It will break him.” One of the talking points from CPR is to characterize the reform package as a “government takeover” of health care. [Politico, 7/17/2009] When Obama says on PBS that “[w]hat they [DeMint and other Republicans] don’t recognize is, this isn’t about me; it’s about the American people… [a]nd things have gotten worse since 1993,” DeMint takes to Fox News to say the argument is about “socialism versus freedom,” and challenge Obama to a debate. “So, I’m glad to have the debate with him,” DeMint says, “but frankly, I’ve been working on health care for over 10 years. I think I know a lot more about how it works than he does. So I’m ready.” [Think Progress, 7/22/2009]

Republican National Committee chairman Michael Steele gives a very direct answer when asked if President Obama’s health care proposal constitutes socialism. During a presentation at the National Press Club, Steele is asked, “Does President Obama’s health care plan represent socialism?” He replies: “Yes. Next question.” MSNBC’s Rachel Maddow notes that Steele is “very sure that reforming health care is socialism even if he’s not actually all that sure what health care policy is,” and plays a video clip of Steele saying at a recent press conference: “I don’t do policy. I’m not—I’m not a legislator.” Steele acknowledges that Republicans made similar assessments of Medicare when it was proposed in 1965, and says: “I think that there’s a legitimate debate there about the impact that Medicare and Medicaid are having on the overall fabric of our economy. I think, though, in this case, unlike 1965, the level of spending, the level of government control and intrusion is far greater and much more expansive than anything we’ve ever seen.… So I think that what we’re talking about here is something far beyond anything we’ve seen in 1965 or since 1965. This is unprecedented government intrusion into the private sector, period. And you can sweeten that any way you want, but it still tastes bitter. And I think the American people know that.” According to Steele, Obama, House Speaker Nancy Pelosi (D-CA), and other Democrats are part of a “cabal” that wants to implement government-run health care. “Obama-Pelosi want to start building a colossal, closed health care system where Washington decides. Republicans want and support an open health care system where patients and doctors make the decisions,” he says. Adding Senate Majority Leader Harry Reid (D-NV) and House Energy and Commerce Committee chairman Henry Waxman (D-CA) into his statement, Steele continues: “Many Democrats outside of the Obama-Pelosi-Reid-Waxman cabal know that voters won’t stand for these kinds of foolish prescriptions for our health care. We do too. That’s why Republicans will stop at nothing to remind voters about the risky experimentation going on in Washington.” Obama and Congressional Democrats are moving too fast to try to enact health care reform, Steele says. “So slow down, Mr. President. We can’t afford to get health care wrong. Your experiment proposes too much, too soon, too fast. Your experiment with our health care could change everything we like about our health care, and our economy as well.” When asked why Republicans are not advancing their own health care proposals, Steele responds: “Now, you know, the Republicans can get up tomorrow and introduce its own bill, but you and I know how Washington works. The bill that matters is the one that the leadership puts in place. The Democrats have the leadership.” [Wall Street Journal, 7/20/2009; Associated Press, 7/20/2009; MSNBC, 7/27/2009]

The American Thinker’s Don Parker makes the false claim that the Democrats’ health care reform proposal will mandate end of life, or advance planning, counseling for every American senior citizen “at a minimum of every five years, more often if the senior is sick or in a nursing home” (see July 21, 2009). Parker cites the provision as being on pages 425-430 of HR 3200, the current version of the health care legislation now pending in the House of Representatives. Parker asks: “Just how many government trained counselors will that put into the work force? With an over 65 population of 38,000,000 US (Census, 2007), four counseling sessions daily, over 37,000, at a minimum, that’s how many. Plus their supervisors, plus the report readers, plus the oversight agency. Don’t even think that anyone should receive mandatory counseling regarding the end of life issues surrounding abortion; that’s a invasion of the right of privacy! ‘Counsel’ a senior about their end of life ‘choices’ under Obama Care? Somehow that’s not the same, so just keep your mouth shut.” [American Thinker, 7/21/2009] As many sources note (see July 23, 2009, July 23, 2009, and Late July, 2009), Parker’s claims are false. Such advance planning counseling sessions would be entirely voluntary, and would not encourage seniors to “die early.”

Senator James Inhofe (R-OK) says that the Republican Party must ensure the total failure of the Obama administration’s attempt to reform American health care for the good of the party’s electoral chances in 2010. Appearing on a radio show, Inhofe says: “They [President Obama and the Democrats] ought to know, they ought to know from history. This is a losing proposition for them. And for those out there who believe, that would like to have something optimistic to look at, we are plotting the demise on a week by week basis of where Bill Clinton was in 1993 and where Obama is today and his demise ratio is greater than Clinton’s was in 1993. So, he’s trying to do the same things, except more extreme.” On another talk radio show, Inhofe adds: “I just hope the president keeps talking about it, keeps trying to rush it through. We can stall it. And that’s going to be a huge gain for those of us who want to turn this thing over in the 2010 election.” [Town Hall (.com), 7/22/2009; Think Progress, 7/23/2009] Senator Robert Menendez (D-NJ) responds to Inhofe’s statements: “Slowly but surely the Republicans are revealing their true strategy on health care: partisans gamesmanship comes before getting something done. If Republicans believe doing nothing will ingratiate themselves with the American people, they have not learned a single lesson from the last two elections. Their do nothing approach is why health care costs have skyrocketed, and it’s why Republicans are in such a bad place today. This strategy is bad politics, but it is also a deeply troubling way to govern.” [Think Progress, 7/23/2009]

House Minority Leader John Boehner (R-OH) and Representative Thaddeus McCotter (R-MI) issue a statement that warns the Obama administration’s health care reform proposal would provide for “government-encouraged euthanasia” of senior citizens. Boehner and McCotter’s statement reads: “Section 1233 of the House-drafted legislation [HR 3200, the most recent version of the reform proposal] encourages health care providers to provide their Medicare patients with counseling on ‘the use of artificially administered nutrition and hydration’ and other end of life treatments, and may place seniors in situations where they feel pressured to sign end of life directives they would not otherwise sign. This provision may start us down a treacherous path toward government-encouraged euthanasia if enacted into law. At a minimum this legislative language deserves a full and open public debate—the sort of debate that is impossible to have under the politically-driven deadlines Democratic leaders have arbitrarily set for enactment of a health care bill.” Boehner and McCotter also state that the reform bill would encourage state-assisted suicide: “With three states having legalized physician-assisted suicide, this provision could create a slippery slope for a more permissive environment for euthanasia, mercy-killing, and physician-assisted suicide because it does not clearly exclude counseling about the supposed benefits of killing oneself. Health care reform that fails to protect the sanctity and dignity of all human life is not reform at all.” [House Republican Leader, 7/23/2009] The next day, McCotter will add: “This is very dangerous. We, in Michigan, have already fought back in attempted assisted suicide several years ago. And yet you see that the people who support this are trying to use this bill to advance this agenda.” [MSNBC, 7/29/2009] The statement is quickly challenged by Representative Earl Blumenauer (D-OR), who with Representative Charles Boustany (R-LA) introduced a separate bill that would provide for end-of-life consultations for senior citizens. Both bills propose nothing more than having Medicare pay for such consultations, if the patients or the patients’ families desire them. “I cannot tell you how disappointed I was to see this type of reaction to a carefully crafted piece of legislation we have been working on for more than six months that is bipartisan and that speaks to the needs of American families,” Blumenauer says. “The American public, especially our senior citizens, deserve our best efforts to meet their needs—not treat them like political footballs.” A Boustany spokesman says the congressman stands behind the measure he co-authored, but says it should include language stating that taxpayer money would not be used to counsel patients on physician-assisted suicide. Two states—Oregon and Washington—allow physician-assisted suicide in certain situations, and the Montana Supreme Court is considering a lower-court ruling that found physician-assisted suicide to be a right under Montana’s Constitution. [Politico, 7/28/2009] Liberal media watchdog organization Media Matters calls the statement’s analysis “repulsive.” [Media Matters, 7/24/2009] The characterization of the bill by Boehner and McCotter will be disproven by a St. Petersburg Times analysis (see July 23, 2009).

PolitiFact logo. [Source: Yahoo! Buzz]The St. Petersburg Times’s “PolitiFact” debunks the recent spate of claims by Betsy McCaughey (R-NY) that the Obama health care reform proposal would mandate ‘death counseling’ (see July 16, 2009) and encourage seniors to die sooner to save money (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 23, 2009, and July 23-24, 2009). Days later, the Annenberg Political FactCheck organization will come to the same conclusions. 'Advance Care Planning Consultation' - According to HR 3200, the latest version of the health care reform legislation, the relevant section is entitled “Advance Care Planning Consultation.” This details how Medicare would pay for voluntary end-of-life counseling sessions. According to the legislation: “such consultation shall include the following: An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to; an explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses; an explanation by the practitioner of the role and responsibilities of a health care proxy.” Medicare will pay for one such session every five years, and will pay for interim sessions if a Medicare recipient’s health worsens in between those five-year sessions. Jon Keyserling, general counsel and vice president of public policy for the National Hospice and Palliative Care Organization, which supports the provision, says the bill does not encourage seniors to end their lives, it just allows some important counseling for decisions that take time and consideration. “These are very serious conversations,” he says. “It needs to be an informative conversation from the medical side and it needs to be thought about carefully by the patient and their families.” According to Jim Dau of the American Association of Retired Persons (AARP), the legislation does not encourage patients to end their lives. Dau says McCaughey’s claims are “not just wrong, they are cruel.” He adds: “We want to make sure people are making the right decision. If some one wants to take every life-saving measure, that’s their call. Others will decide it’s not worth going through this trauma just for themselves and their families, and that’s their decision, too.” Keyserling says it is clear to him and his organization’s lawyers that such end-of-life counseling sessions are purely voluntary, like everything in Medicare. “The only thing mandatory is that Medicare will have to pay for the counseling,” says Dau. A press release from the AARP says that McCaughey’s characterization of the health care bill is “rife with gross—and even cruel—distortions.” [St. Petersburg Times, 7/23/2009; Annenberg Political Fact Check, 7/29/2009]'Scare Tactics' - The St. Petersburg Times concludes: “For our ruling on this one, there’s really no gray area here. McCaughey incorrectly states that the bill would require Medicare patients to have these counseling sessions and she is suggesting that the government is somehow trying to interfere with a very personal decision. And her claim that the sessions would ‘tell [seniors] how to end their life sooner’ is an outright distortion. Rather, the sessions are an option for elderly patients who want to learn more about living wills, health care proxies and other forms of end-of-life planning. McCaughey isn’t just wrong, she’s spreading a ridiculous falsehood.” [St. Petersburg Times, 7/23/2009] The non-partisan FactCheck.org, an organization sponsored by the Annenberg Public Policy Center, will write: “In truth, that section of the bill would require Medicare to pay for voluntary counseling sessions helping seniors to plan for end-of-life medical care, including designating a health care proxy, choosing a hospice, and making decisions about life-sustaining treatment. It would not require doctors to counsel that their patients refuse medical intervention.” The organization will note that inflammatory “chain e-mails” are making the rounds making claims such as: “On Page 425 of Obama’s health care bill, the federal government will require EVERYONE who is on Social Security to undergo a counseling session every five years with the objective being that they will explain to them just how to end their own life earlier. Yes.… They are going to push SUICIDE to cut medicare spending!!!” FactCheck will respond: “In fact, [the part of the bill cited on p. 425] requires Medicare to cover counseling sessions for seniors who want to consider their end-of-life choices—including whether they want to refuse or, conversely, require certain types of care. The claim that the bill would ‘push suicide’ is a falsehood.” FactCheck will find that McCaughey “misrepresent[ed]” the bill in her claims, and she and other health care reform opponents are resorting to “scare tactics” to try to defeat the legislation. [Annenberg Political Fact Check, 7/29/2009]

Patients First bus featuring the “Hands Off Our Health Care” slogan and bloody handprint logo. [Source: Associated Press]The citizens’ organization Patients First, a subsidiary of the conservative lobbying group Americans for Prosperity (AFP—see April 14, 2009, April 15, 2009, and May 29, 2009), schedules a 13-state bus tour. The tour is aimed at bringing conservative protesters to rallies and “town hall” meetings where the White House’s controversial health care proposals are being discussed. AFP’s board includes James Miller, a Federal Trade Commission chairman and budget director during the Reagan administration. The tour begins with a “tea party” rally in Richmond. According to AFP official Ben Marchi, organizers will urge constituents to call or visit their senators and sign a petition that asks members of Congress to “oppose any legislation that imposes greater government control over my health care that would mean fewer choices for me and my family and even deny treatments to those in need.” The bus will make 26 stops in Virginia alone before journeying to North Carolina, Pennsylvania, Indiana, and Louisiana. Another bus will visit Nebraska, Colorado, South Dakota, North Dakota, Montana, Iowa, Arkansas, and Missouri. “Virginians are fired up about health care and what they see as an overreaching federal government,” Marchi says. “We don’t want legislators to come between them and their doctor. The relationship that exists between doctors and patients is sacred and should not be interfered with.” [Richmond Times-Dispatch, 7/23/2009; Politico, 7/28/2009]

CNN reports that millions could be saved per year by the so-called “end of life” discussions that the Obama health care proposal would have Medicare pay for, without a loss in the quality or availability of care. According to a recent study cited by CNN, $76 million per year could be saved “if half of the people who die from cancer annually had end-of-life conversations with their doctors.… [P]atients who reported having those talks had 36 percent lower health care costs in the final week of life.” Most of the savings would come from patients who do not want extraordinary measures taken to preserve their lives, but because hospitals have no such instructions, when a dying patient “codes,” or lapses into a terminal state, hospital doctors by default will use extraordinary methods to resuscitate them. Dr. Arthur Kellerman, chairman of the emergency medicine department at Emory University, says that many aging parents and grandparents avoid such discussions because of the strain they might place on their children and grandchildren. And the younger relatives often avoid these discussions because they don’t want to appear ungrateful or grasping. As for doctors: “There are a lot of my colleagues who don’t bother having that conversation. They just intubate them, and ship them up to an ICU, and say ‘next,’” Kellerman says. “Ultimately, it drives up costs, it degrades their quality of life, and you have less money and less resources available for people who really are salvageable and have a whole lot more time left on Earth.” Kellerman says when his own mother was at the end of his life, he had to use his position as a doctor to ensure that “do not call 911, do not send her to the hospital” was written on her chart so that she would be able to die in her nursing home. “You end up with a daughter at two in the morning, and Grandma is in respiratory failure, and we’re having a conversation in a family room in the ER about what Grandma wants,” Kellerman adds. “That conversation should have been with that grandmother and her daughter and her doctor and should have happened two years earlier, and it would have been easier on everybody.” The study shows that 60 percent of elderly patients prefer that their doctors not use extraordinary measures to preserve their lives. “Everybody wants their parents to live forever, everyone wants to live forever,” says Kellerman. “But the fact is that won’t happen, and you do need to think and plan ahead.” [CNN, 7/23/2009]

Betsy McCaughey, the former lieutenant governor of New York and a lobbyist for the health care industry, writes two frightening op-eds, one for the Wall Street Journal and one for the New York Post, that make false claims about the Democrats’ health care reform package. In the Journal, she claims that the bill contains a provision that would “pressure the elderly to end their lives prematurely,” a claim she has made before (see July 16, 2009). In the Post, she goes much farther, claiming that two of President Obama’s top health care advisers favor denying expensive health care treatments to senior citizens, the mentally disabled, and other “less productive” members of American society. She names Ezekiel Emanuel, a bioethicist, the health care adviser at the White House’s Office of Management and Budget (OMB), and a member of the Federal Council on Comparative Effectiveness Research. She cites a 2008 article by Emanuel in the American Medical Association’s journal, where he wrote that some doctors sometimes go too far, construing the Hippocratic Oath “as an imperative to do everything for the patient regardless of the cost or effects on others.” McCaughey takes Emanuel’s words and accuses him of wanting “doctors to look beyond the needs of their patients and consider social justice, such as whether the money could be better spent on somebody else. Many doctors are horrified by this notion; they’ll tell you that a doctor’s job is to achieve social justice one patient at a time.” McCaughey states that Emanuel believes “medical care should be reserved for the non-disabled, not given to those ‘who are irreversibly prevented from being or becoming participating citizens…’ Translation: Don’t give much care to a grandmother with Parkinson’s or a child with cerebral palsy.” She also claims that Emanuel “explicitly” advocated denying health care to senior citizens in favor of providing treatment to younger patients. McCaughey claims that both Emanuel and Dr. David Blumenthal, the White House’s national coordinator of health information technology, favor “slowing medical innovation to control health spending” and denying patients access to advanced medical technology. According to McCaughey, Blumenthal also favors letting “computers tell… doctors what to do.” She concludes: “No one has leveled with the public about these dangerous views.… Do we want a ‘reform’ that empowers people like this to decide for us?” [Wall Street Journal, 7/23/2009; New York Post, 7/24/2009] A White House official later notes that McCaughey misrepresented Emanuel’s writings, and that Emanuel was describing positions and beliefs that he opposed in the same articles. ABC News’s Jake Tapper will note that Emanuel’s fellow doctors and medical ethicists know him as a fervent advocate of the rights of dying patients. [ABC News, 7/28/2009] And Emanuel himself will rebut McCaughey’s claims (see August 12, 2009). McCaughey’s previous claims about the dangers of health care reform, including her assertion that reform would encourage doctors to let senior citizens die, have been roundly debunked (see July 23, 2009).

Conservatives for Patients’ Rights (CPR), an anti-health care reform lobbying organization owned by former health care industry executive Rick Scott (see August 4, 2009), sends an e-mail to a listserv called the Tea Party Patriots Health Care Reform Committee detailing over 100 “town hall” meetings to take place during the August recess. All are to be hosted by Democratic members of Congress, and most will feature discussions of the White House/Congressional Democrats’ health care reform proposals. [TPMDC, 8/3/2009] The Tea Party Patriots Health Care Reform Committee has hundreds of members on its mailing list, and cross-connects to other, larger mailing lists for anti-reform groups such as Conservatives for Patients Rights (CPR), Patients First, Patients United Now (an affiliate of Americans for Prosperity), and FreedomWorks (see April 14, 2009). CPR features the same list of town hall meetings on its own Web site. The liberal news site TPMDC notes that the same listservs have featured blatantly racist messages such as pictures of President Obama with a bone through his nose (see July 28, 2009). [Conservatives for Patients' Rights, 7/2009; TPMDC, 8/3/2009]

Rep. Louis Gohmert. [Source: Associated Press / Washington Blade]Representative Louis Gohmert (R-TX) lays out a skein of theories on radical radio host Alex Jones’s broadcast. During his interview with Jones, Gohmert accuses the Obama administration and Congressional Democrats of trying to implement socialism and kill senior citizens; Jones and Gohmert compare Obama to a number of foreign despots. Gohmert tells Jones and his listeners: “We’ve been battling this socialist health care, the nationalization of health care, that is going to absolutely kill senior citizens. They’ll put them on lists and force them to die early because they won’t get the treatment as early as they need.… I would rather stop this socialization of health care because once the government pays for your health care, they have every right to tell you what you eat, what you drink, how you exercise, where you live.… But if we’re going to pay 700 million dollars like we voted last Friday to put condoms on wild horses, and I know it just says an un-permanent enhanced contraception whatever the heck that is. I guess it follows that they’re eventually get around to doing it to us.” Gohmert is echoing claims by Republican lawmakers and industry lobbyists that the Democrats’ health care reform proposal will kill senior citizens (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23, 2009, July 23, 2009, and July 23-24, 2009). Jones ups the ante by accusing the White House “science czar” of planning to “put… stuff in the water to sterilize us,” and then goes on to accuse the White House of, among other things, implementing a “eugenics control grid over us” and implementing “youth brigades, national service compulsory in a group outside the military under the Democratic Party control in the city year in the red and black uniforms.” Gohmert agrees with Jones, and says these kinds of policies were “done in the 1930s,” a plain reference to Nazi Germany, “and it’s not the only place its been done. It has been done throughout history.” Jones says, “Mao did it,” referring to Communist China’s Mao Zedong. Gohmert agrees: “Well, that’s exactly what I was thinking of. This is the kind of the thing we got to stop. We got to get back to the roots, the basics.” Gohmert praises Jones for his rhetoric and accusations: “That shows how on top of things you are, Alex.” For his part, Jones effusively thanks Gohmert and reminds him that “you’re there fighting and we’re supporting you.” [Think Progress, 7/27/2009] Progressive MSNBC host Rachel Maddow says of Gohmert and Jones: “You know, the Democrats may be fighting it out about whether they’re going to be beholden to the insurance companies and whether there’s going to be a public option in health care reform. But when it comes to the Republicans, this is the kind of thing they are bringing to the table: Hitler, Mao, and secret plots to kill old people.” [MSNBC, 7/29/2009]

The conservative lobbying group Americans for Prosperity (AFP—see April 15, 2009 and May 29, 2009), in conjunction with the St. Louis Tea Party Coalition, organizes a large protest at a town hall meeting organized by Senator Claire McCaskill (D-MO). Michelle Sherrod, a McCaskill aide, intends to discuss the senator’s opinion on the Obama administration’s health care reform proposals with the protesters, but AFP volunteers and associated protesters have a different agenda. The AFP Web alert says, “We hope we can have a vigorous yet courteous exchange Monday evening,” but according to liberal blog OpenLeft, whose contributors videotape part of the proceedings for YouTube, the conservative protesters—numbering somewhere around 1,000—are disruptive, often preventing Sherrod and other citizens from asking or answering questions. AFP later calls the protest a “smashing success.” The Fox News blog, Fox Nation, celebrates the protest with the headline, “Tea Party Protest Erupts During Senator’s Town Hall!” [Americans for Prosperity, 7/24/2009; Open Left, 7/27/2009; St. Louis Business Journal, 7/27/2009; Americans for Prosperity, 7/28/2009; Fox Nation, 7/29/2009]

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